Mini-ICE regimen as mobilization therapy for chronic myelogenous leukaemia patients at diagnosis.
Between April 1996 and May 1998, 20 consecutive patients with Ph chromosome-positive CML in first chronic phase without an HLA-identical sibling received the mini-ICE regimen shortly after diagnosis to mobilize progenitor cells into the peripheral blood (PBPCs). The sex distribution was 12 males and eight females and the median (range) age 48.5 (22-62) years. The time interval between diagnosis and mobilization was a median (range) of 2 (0-5) months. Leukaphereses were initiated during recovery from chemotherapy-induced aplasia. A median number of 3 (1-7) aphereses per patient were performed to collect >/=2.0 x 106 CD34+cells/kg. Cytogenetic analysis was performed on the aphereses products of 18 patients. Complete cytogenetic Ph chromosome negativity was observed in four patients, nine had a partial negativity, three a minimal negativity and two no negative cells. Southern blot for bcr-abl was negative in the remaining two patients but the polymerase chain reaction analysis was positive. Following reinfusion, severe neutropenia was present for a median of 8.5 (3-19) days and severe thrombocytopenia lasted a median of 8 (3-18) days. Ten patients did not develop febrile neutropenia with four of them being treated on an outpatient basis. Treatment-related mortality was not observed. In conclusion, our experience demonstrates the feasibility of mobilizing PBPCs shortly after the diagnosis of CML with a safe regimen. Of note, mini-ICE allowed the collection of apheresis products with at least a major component of Ph-negative cells in almost 75% of the patients.
Sureda
A
A
Clinical Haematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Petit
J
J
Brunet
S
S
Boqué
C
C
Aventín
A
A
Martino
R
R
González
J R
JR
Amill
B
B
Larriba
I
I
Blanco
A
A
Martín-Henao
G A
GA
Sierra
J
J
Grañena
A
A
D000328:Adult; D018952:Antigens, CD34 / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D001772:Blood Cell Count; D001781:Blood Component Removal / Q000379:methods; D016190:Carboplatin / Q000008:administration & dosage / Q000633:toxicity; D020732:Cytogenetic Analysis; D005047:Etoposide / Q000008:administration & dosage / Q000633:toxicity; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000633:toxicity; D016898:Interferon-alpha / Q000627:therapeutic use; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D007958:Leukocyte Count; D007963:Leukocytes, Mononuclear; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010677:Philadelphia Chromosome; D010976:Platelet Count; D013997:Time Factors; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D016898:Interferon-alpha; D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide