TY - JOUR
T1 - Conventional intensive therapy can lead to overshoot of PH‐negative blood cells in chronic myeloid leukemia
AU - Carella, A. M.
AU - Podestá, M.
AU - Carlier, P.
AU - Raffo, M. R.
AU - Pollicardo, N.
AU - Gualandi, F.
PY - 1992
Y1 - 1992
N2 - Twenty‐six patients with Philadelphia chromosome (Ph)‐positive in advanced phase (AP) (24 patients) or in chronic phase (CP) (2 patients) chronic myeloid Leukemia (CML), who were inelegible for allogeneic BMT, were given a new intensive treatment consisting of Idarubicin, 6–8mg/m2 per day for 5 days, ARA‐C, 600–800mg/m2 per day for 5 days infused i.v. over 2h and Etoposide 150mg/m2 per day for 3 days infused over 2h. During recovery of marrow aplasia, when the WBC count reached 0.3‐1×109, blood The International Journal of Cell Cloning (BSC) were collected with 4–5 consecutive leukapheresis. In 8/24 (30%) AP‐CML and in 1/2 (50%) CP‐CML, these BSC were Ph‐negative. Moreover, in two cases (1 advanced and 1 chronic) the PCR analysis performed to detect the presence of minimal residual disease in the cells collected by leukapheresis were negative, further confirming that this approach may induce a very high degree of suppression of the Ph‐positive clone. After recovery, Ph negative patients were subsequently treated with high‐dose Cyclophosphamide ± Etoposide and Total body irradiation (10 Gy, single dose) followed by reinfusion of Ph‐negative cells. Subsequently, all these patients received Cyclosporine A post‐BSC reinfusion in an attempt to induce acute GVHD. Two of 8 patients in AP‐CML and the patient treated in CP remain in clinical and cytogenetic remission post‐transplant. We conclude that Ph‐negative BSC can be recovered from patients in CP‐CML but also in AP‐CML and used successfully to restore Ph‐negative hemopoiesis after very intensive chemoradiotherapy programs.
AB - Twenty‐six patients with Philadelphia chromosome (Ph)‐positive in advanced phase (AP) (24 patients) or in chronic phase (CP) (2 patients) chronic myeloid Leukemia (CML), who were inelegible for allogeneic BMT, were given a new intensive treatment consisting of Idarubicin, 6–8mg/m2 per day for 5 days, ARA‐C, 600–800mg/m2 per day for 5 days infused i.v. over 2h and Etoposide 150mg/m2 per day for 3 days infused over 2h. During recovery of marrow aplasia, when the WBC count reached 0.3‐1×109, blood The International Journal of Cell Cloning (BSC) were collected with 4–5 consecutive leukapheresis. In 8/24 (30%) AP‐CML and in 1/2 (50%) CP‐CML, these BSC were Ph‐negative. Moreover, in two cases (1 advanced and 1 chronic) the PCR analysis performed to detect the presence of minimal residual disease in the cells collected by leukapheresis were negative, further confirming that this approach may induce a very high degree of suppression of the Ph‐positive clone. After recovery, Ph negative patients were subsequently treated with high‐dose Cyclophosphamide ± Etoposide and Total body irradiation (10 Gy, single dose) followed by reinfusion of Ph‐negative cells. Subsequently, all these patients received Cyclosporine A post‐BSC reinfusion in an attempt to induce acute GVHD. Two of 8 patients in AP‐CML and the patient treated in CP remain in clinical and cytogenetic remission post‐transplant. We conclude that Ph‐negative BSC can be recovered from patients in CP‐CML but also in AP‐CML and used successfully to restore Ph‐negative hemopoiesis after very intensive chemoradiotherapy programs.
KW - ARA‐C
KW - Etoposide
KW - Idarubicin
KW - Ph negative peripheral The International Journal of Cell Cloning
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U2 - 10.1002/stem.5530100738
DO - 10.1002/stem.5530100738
M3 - Article
AN - SCOPUS:84995047874
VL - 10
SP - 117
EP - 123
JO - International Journal of Cell Cloning
JF - International Journal of Cell Cloning
SN - 0737-1454
IS - 1 S
ER -