Peripheral blood progenitor cell collection in chronic myeloid leukemia patients with complete cytogenetic response after treatment with imatinib mesylate.
BACKGROUND
Imatinib mesylate (IM) was introduced in chronic myeloid leukemia (CML) treatment in the late 1990s and substantially changed the therapeutic approach to the disease, by inducing complete cytogenetic response (CCR) in approximately 60 percent of cases. Nevertheless, some concerns exist about the duration of response to treatment and the onset of resistance to IM.


METHODS
Twenty-five chronic-phase CML patients in stable CCR (>6 months) treated for at least 1 year with IM at the standard dose (400 mg/day) were mobilized with recombinant human granulocyte-colony-stimulating factor (Filgrastim) at 10 microg per kg for 4 to 6 days, with the aim of collecting at least 2 x 10(6) CD34+ cells per kg. Standard cytogenetic analysis and first-round and/or nested polymerase chain reaction were performed in basal and postmobilization samples to examine the presence of bcr-abl transcripts.


RESULTS
CD34+ cells collection was successful in 16 patients, yielding a median of 3.01 x 10(6) +/- 1.09 x 10(6) CD34+ cells per kg at the first attempt, and in 4 of the 9 remaining patients who were remobilized after a temporary withdrawal of IM, yielding a median of 2.65 x 10(6) +/- 0.7 x 10(6) CD34+ cells per kg, with an overall 80 percent success rate. No correlation between mobilization and duration of the disease, length of IM treatment, or previous interferon-alpha and/or hydroxyurea treatment was found.


CONCLUSIONS
Autologous CD34+ cells may be mobilized and collected in most CML patients who achieve CCR after IM treatment, with a view to possible use in the event that resistance to IM occurs in patients not eligible for allogeneic peripheral blood progenitor cell transplantation or those lacking an HLA-matched donor.
Department of Clinical Pathology-Immunohematology and Transfusion Service, Therapeutic Apheresis Unit, San Gerardo de' Tintori Hospital, Monza, Italy. p.perseghin@hsgerardo.org
Paolo
P
Perseghin
Carlo
C
Gambacorti-Passerini
Lucia
L
Tornaghi
Maria
M
Dassi
Pietro
P
Pioltelli
Matteo
M
Parma
Federica
F
Colnaghi
Giovanni
G
Giudici
Elena
E
Elli
Monica
M
Fumagalli
Luisa
L
Ponchio
Andrea
A
Biondi
Enrico M
EM
Pogliani
D018952:Antigens, CD34 / Q000032:analysis; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D001781:Blood Component Removal; D002470:Cell Survival; D002478:Cells, Cultured; D002871:Chromosome Banding; D003114:Colony-Forming Units Assay; D020732:Cytogenetic Analysis; D005240:Feasibility Studies; D000069585:Filgrastim; D005434:Flow Cytometry; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006412:Hematopoietic Stem Cells / Q000166:cytology*; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D018655:Lymphocyte Count; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D018952:Antigens, CD34; D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000068877:Imatinib Mesylate; D000069585:Filgrastim