title: Chemotherapy for mobilisation of Ph-negative progenitor cells from patients with CML: impact of different mobilisation regimens.
abstract: Mobilised peripheral blood stem cells are widely used for autografting in patients with chronic myeloid leukaemia (CML) and it is generally thought that a high proportion of Ph-negative progenitor cells in the graft is desirable. We report here the results of 91 stem cell mobilisations performed with various chemotherapy regimens followed by G-CSF. We show that mobilisation of Ph-negative cells is possible after diagnosis as well as in advanced stages of the disease. The yield of Ph-negative cells is highly dependent on the chemotherapy regimen: while the combination of idarubicin and cytarabin for 3-5 days (IC3-5) mobilised Ph-negative cells in most patients, high-dose cyclophosphamide was ineffective. Mobilisation of Ph-negative progenitor cells after IC3 was at least as effective as after IC5; however, less apheresis sessions were required, and toxicity was much reduced after IC3. Compared to historical controls, IC was equally effective as the widely used ICE/miniICE (idarubicin, cytarabin, etoposide) protocol. No correlation was found between graft quality and the cytogenetic response to subsequent treatment with interferon-alpha. We conclude that IC3 is an effective and well-tolerated regimen for mobilising Ph-negative cells that compares well with more aggressive approaches such as IC5 and ICE/miniICE.
authors.affiliation: Department of Hematology, University of Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Deininger
authors.forename: W
authors.initials: W
authors.lastname: Pönisch
authors.forename: R
authors.initials: R
authors.lastname: Krahl
authors.forename: S
authors.initials: S
authors.lastname: Leiblein
authors.forename: E
authors.initials: E
authors.lastname: Edel
authors.forename: T
authors.initials: T
authors.lastname: Lange
authors.forename: F
authors.initials: F
authors.lastname: Fiedler
authors.forename: M
authors.initials: M
authors.lastname: Freund
authors.forename: A
authors.initials: A
authors.lastname: Franke
authors.forename: R
authors.initials: R
authors.lastname: Pasold
authors.forename: U
authors.initials: U
authors.lastname: von Grünhagen
authors.forename: M
authors.initials: M
authors.lastname: Herold
authors.forename: G
authors.initials: G
authors.lastname: Dölken
authors.forename: F A
authors.initials: FA
authors.lastname: Hoffmann
authors.forename: R
authors.initials: R
authors.lastname: Uhle
authors.forename: W
authors.initials: W
authors.lastname: Schultze
authors.forename: J
authors.initials: J
authors.lastname: Steglich
authors.forename: A
authors.initials: A
authors.lastname: Schwarzer
authors.forename: P
authors.initials: P
authors.lastname: Richter
authors.forename: C
authors.initials: C
authors.lastname: Winkelmann
authors.forename: E
authors.initials: E
authors.lastname: Kettner
authors.forename: K
authors.initials: K
authors.lastname: Dachselt
authors.forename: R
authors.initials: R
authors.lastname: Subert
authors.forename: E
authors.initials: E
authors.lastname: Schwalbe
authors.forename: J
authors.initials: J
authors.lastname: Doepper
authors.forename: W
authors.initials: W
authors.lastname: Helbig
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000494:pharmacology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D003561:Cytarabine / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods* / Q000592:standards; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000592:standards / Q000633:toxicity; D016898:Interferon-alpha / Q000008:administration & dosage; D007937:Leukapheresis / Q000592:standards; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010677:Philadelphia Chromosome
chemical_list: D016898:Interferon-alpha; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D003520:Cyclophosphamide; D015255:Idarubicin