Collection of 'normal' blood repopulating cells during early hemopoietic recovery after intensive conventional chemotherapy in chronic myelogenous leukemia.
Twenty-five patients with CML (chronic phase (CP): 15 patients; accelerated phase (AP): 10 patients) at a median of 40 months after diagnosis and ineligible for allogeneic BMT, received an intensive chemotherapy regimen consisting of idarubicin, intermediate-dose ara-C and etoposide (ICE protocol). All patients had previously received alpha-interferon and only two patients had had partial cytogenetic response. During recovery from chemotherapy-induced aplasia, blood progenitors cells (BPC) were harvested by leukapheresis. All metaphases were found to be Ph-negative in the collection of 12 of 25 (48%) patients (CP: 9 of 15 (60%), AP: 3 of 10 (30%)) and a decrease of < 50% Ph-positive metaphases was seen in an additional five (CP: 4 patients; AP: 1 patient). The percentage of complete Ph-disappearance was 66% in patients receiving this procedure within the first 2 years of diagnosis and 30% in those treated after the second year of diagnosis. So far, the Ph-negative collections have been used in 9 patients (CP: 8 patients; AP: 1 patient) as autograft after conditioning with total body irradiation/etoposide/CY. Seven of 9 patients engrafted and 5 are alive and well, Ph-negative at 2+, 3+, 6+, 10+ and 18+ months.
Carella
A M
AM
Hematology and Autologous Bone Marrow Transplantation Unit, Ospedale S. Martino, Genoa, Italy.
Podesta
M
M
Frassoni
F
F
Raffo
M R
MR
Pollicardo
N
N
Pungolino
E
E
Vimercati
R
R
Sessarego
M
M
Parodi
C
C
Rabitti
C
C
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016913:Blood Component Transfusion; D001804:Blood Transfusion, Autologous; D002469:Cell Separation; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells; D006801:Humans; D015255:Idarubicin / Q000627:therapeutic use; D007155:Immunologic Factors / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood* / Q000188:drug therapy / Q000628:therapy; D015465:Leukemia, Myeloid, Accelerated Phase / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D015466:Leukemia, Myeloid, Chronic-Phase / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis; D012334:RNA, Neoplasm / Q000032:analysis; D011994:Recombinant Proteins / Q000627:therapeutic use; D012074:Remission Induction; D013997:Time Factors; D016896:Treatment Outcome
D007155:Immunologic Factors; D016898:Interferon-alpha; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D011994:Recombinant Proteins; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D005047:Etoposide; D016044:Fusion Proteins, bcr-abl; D015255:Idarubicin