Autografting Ph-negative blood precursor cells in chronic myeloid leukaemia.
The study was devised to evaluate whether it was possible to collect Philadelphia-negative precursor cells in patients with chronic myeloid leukaemia. The approach was based on previous experience showing that complete remission (Ph-negative bone marrow cells) is rarely achieved after chemotherapy and is very short-lasting. We decided to explore whether it was possible to collect Ph-negative precursor cells in peripheral blood during the early phase of haemopoietic recovery. These data show that: the collection of Ph-negative precursor cells occurred in 12/16 (75%) patients mobilized within one year of diagnosis (group A) versus 12/33 (36%) in patients with a history of more than one year of disease (group B). Furthermore the numbers of Ph-negative precursor cells were significantly much higher at diagnosis. Ten patients mobilized at diagnosis were subsequently autografted with such Ph-negative precursor cells. Five of them remain Ph-negative from 4 to 12 months while the other five have percentages of Ph-positive cells in their marrow ranging from 20% to 70%. In this stage of the disease the procedure is safe and associated with a very good compliance. Occasional restoration of Ph-negative haemopoiesis could be observed up to 40 months after autograft, in patients of group B, but most of patients revert to Ph-positive haemopoiesis. in conclusion these data suggest that it is possible to restore Ph-negative haemopoiesis in 70% of patients mobilized at diagnosis. This percentage represent the highest one can obtain without allogeneic BMT, and this includes patients who never would have been cytogenetic responders to IFN-alpha. Whether and how long for Ph-negative status can be maintained is a matter for future observation and study.
Frassoni
F
F
Dipartimento Ematologia, Ospedale San Martino, Genova, Italy.
Giordano
D
D
Podestà
M
M
Piaggio
G
G
Benvenuto
F
F
Pitto
A
A
Figari
O
O
Dejana
A
A
Lerma
E
E
Vassallo
F
F
Sessarego
M
M
Carella
A
A
D000328:Adult; D001773:Blood Cells / Q000648:ultrastructure; D016026:Bone Marrow Transplantation; D002985:Clinical Protocols; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000648:ultrastructure; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007937:Leukapheresis; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000235:genetics / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D016898:Interferon-alpha