Intensive chemotherapy, total body irradiation, and autologous marrow transplantation for chronic granulocytic leukemia-blast phase: report of four additional cases

J Clin Oncol. 1984 May;2(5):379-84. doi: 10.1200/JCO.1984.2.5.379.

Abstract

Four patients with Philadelphia chromosome (Ph1)-positive chronic granulocytic leukemia (CGL) in blast phase received cyclophosphamide, total body irradiation, and autologous marrow transplants using cryopreserved marrow from the stable phase. Two patients fully reestablished stable-phase leukemia that lasted for 26 and six months; the first patient developed transient Ph1-negative hematopoiesis after transplantation. Three patients eventually died of recurrent blast-phase leukemia. Previous studies using autologous marrow for CGL have reported an occasional long survivor, but incomplete engraftment and especially the rapid recurrence of blast-phase leukemia have been responsible for the overall poor results. The latter problem complicates even normal marrow transplantation, indicating the inadequacy of the current therapeutic regimens used for treating blast-phase leukemia and the possibility of improving results with more effective regimens and autologous marrow transplantation. Although it is unknown whether the reestablishment of Ph1-negative hematopoiesis after transplantation contributes to improved survival, this interesting phenomenon must be investigated further.

Publication types

  • Case Reports
  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bone Marrow / ultrastructure
  • Bone Marrow Transplantation*
  • Busulfan / therapeutic use
  • Child
  • Chromosomes, Human, 21-22 and Y
  • Chronic Disease
  • Cyclophosphamide / therapeutic use*
  • Follow-Up Studies
  • Hematopoiesis
  • Humans
  • Karyotyping
  • Leukemia, Myeloid, Acute / therapy*
  • Recurrence
  • Splenomegaly
  • Whole-Body Irradiation*

Substances

  • Cyclophosphamide
  • Busulfan