title: Mobilization and transplantation of Philadelphia-negative peripheral-blood progenitor cells early in chronic myelogenous leukemia.
abstract: OBJECTIVE
  Mobilization of Philadelphia (Ph) chromosome-negative progenitors is now possible in many Ph1-positive chronic myelogenous leukemia (CML) patients who had received interferon alfa (IFN-alpha) with no cytogenetic response. In this pilot study, we used this approach in patients without prior IFN-alpha therapy to determine if the number and quality of mobilized progenitors would be increased and to evaluate the potential effect of these cells as autografts.
  
  
  METHODS
  Twenty-two untreated patients were mobilized within 12 months of diagnosis. The treatment regimen consisted of the mini-ICE protocol. Beginning on day +8, granulocyte colony-stimulating factor (G-CSF) was used in all patients. Leukophoresis was performed as the patients were recovering from aplasia, when WBC count exceeded 0.8 x 10(9)/L.
  
  
  RESULTS
  In 14 patients, (63%) the leukophoresis product was entirely Ph1-negative and in four patients the Ph1-positive cell rate was < or = 7%. Significant numbers of long-term culture-initiating cells (LTC-IC) and CD34+ Thy1+Lin- cells were found in most of the Ph1-negative collections that were tested. Twelve patients underwent autografting with their mobilized peripheral-blood progenitor cells (PBPC) (Ph1-negative collections, 10 patients; major cytogenetic response, two patients). All patients engrafted and are alive; six have Ph1-negative marrow 7 to 15 months after autografting. Posttransplant treatment was IFN-alpha combined with interleukin (IL)-2 because of the recent demonstration of synergistic activity in augmenting cytolytic activity.
  
  
  CONCLUSIONS
  Intensive chemotherapy given in early chronic phase of CML is well tolerated and results in high numbers of circulating Ph1-negative precursor cells.
authors.affiliation: Hematology and Autologous Bone Marrow Transplant Unit, Ospedale San Martino, Genova, Italy.
authors.forename: A M
authors.initials: AM
authors.lastname: Carella
authors.forename: I
authors.initials: I
authors.lastname: Cunningham
authors.forename: E
authors.initials: E
authors.lastname: Lerma
authors.forename: A
authors.initials: A
authors.lastname: Dejana
authors.forename: F
authors.initials: F
authors.lastname: Benvenuto
authors.forename: M
authors.initials: M
authors.lastname: Podestà
authors.forename: L
authors.initials: L
authors.lastname: Celesti
authors.forename: F
authors.initials: F
authors.lastname: Chimirri
authors.forename: M
authors.initials: M
authors.lastname: Abote
authors.forename: F
authors.initials: F
authors.lastname: Vassallo
authors.forename: O
authors.initials: O
authors.lastname: Figari
authors.forename: C
authors.initials: C
authors.lastname: Parodi
authors.forename: M
authors.initials: M
authors.lastname: Sessarego
authors.forename: M
authors.initials: M
authors.lastname: Valbonesi
authors.forename: P
authors.initials: P
authors.lastname: Carlier
authors.forename: E
authors.initials: E
authors.lastname: Prencipe
authors.forename: A M
authors.initials: AM
authors.lastname: Gatti
authors.forename: D
authors.initials: D
authors.lastname: van den Berg
authors.forename: R
authors.initials: R
authors.lastname: Hoffman
authors.forename: F
authors.initials: F
authors.lastname: Frassoni
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000187:drug effects; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome; D010865:Pilot Projects; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016898:Interferon-alpha