Autologous transplant for chronic myelogenous leukemia using marrow treated ex vivo with mafosfamide

C. Carlo-Stella, L. Mangoni, C. Almici, C. Caramatti, L. Cottafavi, G. P. Dotti, V. Rizzoli

Research output: Contribution to journalArticle

Abstract

Ten adult patients with Ph-positive chronic myelogenous leukemia (CML) received autologous transplantation using marrow treated ex vivo with mafosfamide. At transplant, 7 patients were in chronic phase (5 in first, 2 in second) and 3 in accelerated phase. The median time to achieve 500 x 106/l neutrophils was 32 days (range 17-72 days). A platelet count of 20 X 109/l was achieved at a median of 40 days (range 24-151 days). After transplant, cytogenetic analysis revealed 100% Ph-negative marrow metaphases in 6 of 9 analyzable patients with a median duration of Ph-negative hematopoiesis of 6.5 months. After a median follow-up of 16 months (range 3-31 months), five patients evolved into blast crisis, two died of non-hematological causes, one is Ph-negative in chronic phase at +4 and one is in chronic phase, but Ph-positive, at +22. In conclusion, this pilot study demonstrates that: (1) engraftment can occur from Ph-negative stem cells selected by mafosfamide, (2) mafosfamide purging may induce a transient period of Ph-negative hematopoiesis, and (3) modifications of the purging procedure and post-transplant manipulations of the immune-hematopoietic system are required to prolong cytogenetic remission.

Original languageEnglish
Pages (from-to)425-432
Number of pages8
JournalBone Marrow Transplantation
Volume14
Issue number3
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Carlo-Stella, C., Mangoni, L., Almici, C., Caramatti, C., Cottafavi, L., Dotti, G. P., & Rizzoli, V. (1994). Autologous transplant for chronic myelogenous leukemia using marrow treated ex vivo with mafosfamide. Bone Marrow Transplantation, 14(3), 425-432.