Cytogenetic events after bone marrow transplantation for Philadelphia chromosome positive chronic myeloid leukemia.
Allogeneic bone marrow transplantation is the only way to cure patients with Ph1+ chronic myeloid leukemia. It is commonly assumed that, in order to obtain a cure for the patients, the leukemic clone must be completely destroyed by the conditioning treatment and the donor's bone marrow must repopulate the hemopoietic niches leading to a "complete chimera". However, cytogenetic analyses, supported by molecular ones, indicate that Ph1+ cells, far from being completely destroyed by chemo-radiotherapy may persist for a long time, probably in the majority of the patients. As demonstrated by the outcome of patients receiving T-cell depleted marrow, immune mechanisms must be involved in controlling and progressively reducing the size of the residual leukemic clone. Furthermore, immunodulating therapeutic strategies, represented by cyclosporin-A discontinuation or alpha interferon treatment, may successfully reduce the Ph1+ cell population even after a full relapse.
Zaccaria
A
A
Institute of Hematology Lorenzo e Ariosto Sergnoli, University of Bologna, Italy.
Rosti
G
G
Testoni
N
N
Santucci
M A
MA
Tassinari
A
A
Celso
B
B
Buzzi
M
M
Miggiano
M C
MC
Tura
S
S
D016026:Bone Marrow Transplantation / Q000473:pathology / Q000502:physiology*; D003582:Cytogenetics; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D014184:Transplantation, Homologous