In vitro marrow purging in chronic myelogenous leukemia: Effect of mafosfamide and recombinant granulocyte-macrophage colony-stimulating factor

C. Carlo-Stella, L. Mangoni, G. Piovani, C. Almici, D. Garau, C. V. Caramatti Rizzoli

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Abstract

Clinical and experimental evidence revealing Ph1-negative hematopoietic stem cells in the majority of chronic myelogenous leukemia (CML) patients, suggests that autologous bone marrow transplantation (ABMT) may represent a therapeutic approach for these patients. It was the aim of the present study to evaluate the efficacy of the cyclophosphamide derivative mafosfamide as a marrow purging agent in a group (n = 15) of CML patients. Chemical purging was followed by a short-term liquid culture phase supplemented with recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF). Mafosfamide (100 μg/ ml) incubation induced a marked inhibition of progenitor cell growth, the percentages of surviving CFU-GEMM, BFU-E, and CFU-GM being 3.4, 5.4, and 4.9, respectively. At the cytogenetic level, the purging procedure failed to show any modulating effect on Ph1-negative clones in 9/15 cases. In contrast, 6/15 cases showed a significant increase in the mean (± SD) percentage of Ph1-negative metaphases in response to rGM-CSF (46 ± 26, p ≤ 0.05), mafosfamide incubation (53 ± 12, p ≤ 0.01), and the combination of mafosfamide incubation plus rGM-CSF (63 ± 29, p ≤ 0.025). Immunological analysis revealed that mafosfamide incubation induced a significant enrichment of MY10 (28 ± 9, p ≤ 0.05), IL2-receptor (34 ± 10, p ≤ 0.05) B73.1-positive cells (25 ± 9, p ≤ 0.05). Four mafosfamide-responsive patients with CML in second chronic phase have been autografted with mafosfamide purged marrow. In all patients a Ph1-negative phase lasting 5-14 months was observed. In conclusion, it appears that (a) in a subgroup of CML patients mafosfamide purging is effective in reducing the size of the malignant clone and might induce through its cytotoxic and immune actions a modification of the balance between leukemic and normal clones, and (b) this experimental approach may be used as a screening test to select patients to undergo marrow harvest and ABMT with mafosfamide purged marrow.

Original languageEnglish
Pages (from-to)265-273
Number of pages9
JournalBone Marrow Transplantation
Volume8
Issue number4
Publication statusPublished - 1991

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Granulocyte-Macrophage Colony-Stimulating Factor
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Bone Marrow
Clone Cells
Autologous Transplantation
Bone Marrow Transplantation
Myeloid Progenitor Cells
In Vitro Techniques
mafosfamide
Granulocyte-Macrophage Progenitor Cells
Erythroid Precursor Cells
Interleukin-2 Receptors
Metaphase
Hematopoietic Stem Cells
Cytogenetics
Cyclophosphamide
Stem Cells
Growth

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

In vitro marrow purging in chronic myelogenous leukemia : Effect of mafosfamide and recombinant granulocyte-macrophage colony-stimulating factor. / Carlo-Stella, C.; Mangoni, L.; Piovani, G.; Almici, C.; Garau, D.; Caramatti Rizzoli, C. V.

In: Bone Marrow Transplantation, Vol. 8, No. 4, 1991, p. 265-273.

Research output: Contribution to journalArticle

Carlo-Stella, C. ; Mangoni, L. ; Piovani, G. ; Almici, C. ; Garau, D. ; Caramatti Rizzoli, C. V. / In vitro marrow purging in chronic myelogenous leukemia : Effect of mafosfamide and recombinant granulocyte-macrophage colony-stimulating factor. In: Bone Marrow Transplantation. 1991 ; Vol. 8, No. 4. pp. 265-273.
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abstract = "Clinical and experimental evidence revealing Ph1-negative hematopoietic stem cells in the majority of chronic myelogenous leukemia (CML) patients, suggests that autologous bone marrow transplantation (ABMT) may represent a therapeutic approach for these patients. It was the aim of the present study to evaluate the efficacy of the cyclophosphamide derivative mafosfamide as a marrow purging agent in a group (n = 15) of CML patients. Chemical purging was followed by a short-term liquid culture phase supplemented with recombinant granulocyte-macrophage colony-stimulating factor (rGM-CSF). Mafosfamide (100 μg/ ml) incubation induced a marked inhibition of progenitor cell growth, the percentages of surviving CFU-GEMM, BFU-E, and CFU-GM being 3.4, 5.4, and 4.9, respectively. At the cytogenetic level, the purging procedure failed to show any modulating effect on Ph1-negative clones in 9/15 cases. In contrast, 6/15 cases showed a significant increase in the mean (± SD) percentage of Ph1-negative metaphases in response to rGM-CSF (46 ± 26, p ≤ 0.05), mafosfamide incubation (53 ± 12, p ≤ 0.01), and the combination of mafosfamide incubation plus rGM-CSF (63 ± 29, p ≤ 0.025). Immunological analysis revealed that mafosfamide incubation induced a significant enrichment of MY10 (28 ± 9, p ≤ 0.05), IL2-receptor (34 ± 10, p ≤ 0.05) B73.1-positive cells (25 ± 9, p ≤ 0.05). Four mafosfamide-responsive patients with CML in second chronic phase have been autografted with mafosfamide purged marrow. In all patients a Ph1-negative phase lasting 5-14 months was observed. In conclusion, it appears that (a) in a subgroup of CML patients mafosfamide purging is effective in reducing the size of the malignant clone and might induce through its cytotoxic and immune actions a modification of the balance between leukemic and normal clones, and (b) this experimental approach may be used as a screening test to select patients to undergo marrow harvest and ABMT with mafosfamide purged marrow.",
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