Autografting in chronic myeloid leukemia

Autografting (or autologous stem cell transplant [ASCT]) followed by "rescue" with Philadelphia chromosome (Ph)-negative hematopoietic progenitor cells (HPC) remains a good procedure to guarantee prolonged survival for patients mobilized and autografted soon after diagnosis. Among 50 autografted patients who were treated with interferon alpha (IFN-α) and imatinib (for cytogenetic relapse after IFN-α), 41 are alive at a median of 51 months (range, 8 to 106 months). Twenty-eight (56%) patients maintain major cytogenetic remission after ASCT + IFN-α ± imatinib. Such results are probably better than those achieved by IFN-α alone and are similar to the best results obtained in younger patients after allografting with human leukocyte antigen (HLA)-identical sibling donors. The integration of imatinib, during the coming years, into an autografting procedure could represent important progress towards developing a cure for chronic myeloid leukemia (CML) patients who cannot undergo conventional allografting.