Abstract
Twenty-five patients with CML (chronic phase (CP): 15 patients; accelerated phase (AP): 10 patients) at a median of 40 months after diagnosis and ineligible for allogeneic BMT, received an intensive chemotherapy regimen consisting of idarubicin, intermediate-dose ara-C and etoposide (ICE protocol). All patients had previously received alpha-interferon and only two patients had had partial cytogenetic response. During recovery from chemotherapy-induced aplasia, blood progenitors cells (BPC) were harvested by leukapheresis. All metaphases were found to be Ph-negative in the collection of 12 of 25 (48%) patients (CP: 9 of 15 (60%), AP: 3 of 10 (30%)) and a decrease of < 50% Ph-positive metaphases was seen in an additional five (CP: 4 patients; AP: 1 patient). The percentage of complete Ph-disappearance was 66% in patients receiving this procedure within the first 2 years of diagnosis and 30% in those treated after the second year of diagnosis. So far, the Ph-negative collections have been used in 9 patients (CP: 8 patients; AP: 1 patient) as autograft after conditioning with total body irradiation/etoposide/CY. Seven of 9 patients engrafted and 5 are alive and well, Ph-negative at 2+, 3+, 6+, 10+ and 18+ months.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Blood Component Transfusion*
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Blood Transfusion, Autologous*
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Cell Separation
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Combined Modality Therapy
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Cytarabine / therapeutic use
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Etoposide / therapeutic use
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Female
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Fusion Proteins, bcr-abl / genetics
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Granulocyte Colony-Stimulating Factor / therapeutic use
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Hematopoietic Stem Cell Transplantation
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Hematopoietic Stem Cells*
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Humans
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Idarubicin / therapeutic use
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Immunologic Factors / therapeutic use
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Interferon-alpha / therapeutic use
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / blood*
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy
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Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
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Leukemia, Myeloid, Accelerated Phase / blood*
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Leukemia, Myeloid, Accelerated Phase / drug therapy
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Leukemia, Myeloid, Accelerated Phase / pathology
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Leukemia, Myeloid, Accelerated Phase / therapy
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Leukemia, Myeloid, Chronic-Phase / blood*
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Leukemia, Myeloid, Chronic-Phase / drug therapy
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Leukemia, Myeloid, Chronic-Phase / pathology
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Leukemia, Myeloid, Chronic-Phase / therapy
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Male
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Middle Aged
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Polymerase Chain Reaction
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RNA, Messenger / analysis
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RNA, Neoplasm / analysis
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Recombinant Proteins / therapeutic use
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Remission Induction
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Time Factors
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Treatment Outcome
Substances
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Immunologic Factors
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Interferon-alpha
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RNA, Messenger
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RNA, Neoplasm
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Recombinant Proteins
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Cytarabine
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Granulocyte Colony-Stimulating Factor
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Etoposide
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Fusion Proteins, bcr-abl
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Idarubicin