Intensive conventional chemotherapy can lead to a precocious overshoot of cytogenetically normal blood stem cells (BSC) in chronic myeloid leukemia and acute lymphoblastic leukemia

A. M. Carella, N. Pollicardo, M. R. Raffo, M. Podesta', P. Carlier, M. Valbonesi, G. Lercari, V. Vitale, A. Gallamini

Research output: Contribution to journalArticlepeer-review

Abstract

Forty patients with Ph-positive blastic phase (BP) (28 patients) or chronic phase (CP)-CML (3 patients) and relapsed adult acute lymphoblastic leukemia (ALL) (9 patients) with cytogenetical traslocations [t(8;14):2 patients; t(4;8):2 patients; t(4;11):3 patients; t(9;22):2 patients], received an intensive conventional chemotherapy. During early recovery from marrow aplasia, when WBC reached 0.3-1.5 × 10 ̂ 9/L, peripheral blood stem cells (BSC) were collected by 4-8 leukapheresis consecutively. BSC collected from the 2/3 patients with CP-CML resulted Ph-negative and PCR negative. In 8 out of 26 BP-CML patients, BSC resulted Ph-negative and in two cases PCR negative. Of the nine ALL patients, 6 patients lost the cytogenetic traslocations, one patient died during aplasia, two patients did not have cytogenetic modifications and died in few weeks of leukemia and one patient out of six responding patients relapsed before transplant. After complete recovery, 15 patients (BP-CML:8 patients; CP-CML:2 patients; ALL: 5 patients) were subsequently given high-dose therapy (VP-16 ± Cy+TBI in single dose) followed by reinfusion of "normal" BSC. Both the patients in CP-CML and 5/5 patients with ALL maintain clinical and cytogenetic remission; all the patients transplanted in BP-CML relapsed 5-18 months post-transplant. It is concluded that intensive conventional chemotherapy employed in CML and ALL can lead to a precocious overshoot of cytogenetically normal BSC. Autologous bone marrow transplantation (ABMT) has become an accepted new methodology in the management of hematological neoplasias, and, more recently, also in solid tumors. One alternative to ABMT is the use of hematopoietic stem cells collected from peripheral blood. Peripheral blood stem cell transplantation (BSCT) is a viable alternative to ABMT and offers various advantages over ABMT that consists of more rapid hematological recovery after high-dose therapy, collection without general anesthesia, the chance of performing BSCT in pa-tients with residual marrow disease and/or fibrosis (1), and last, but not less important, the chance of taking Ph-negative stem cell in patients with Ph-positive chronic myeloid Leukemia (CML) (2). The purpose of this study was to update our experience with this technique on patients with CML and to give informations on patients with ALL with karyotypic traslocations.

Original languageEnglish
Pages (from-to)120-122
Number of pages3
JournalLeukemia
Volume6
Issue numberSUPPL. 4
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Intensive conventional chemotherapy can lead to a precocious overshoot of cytogenetically normal blood stem cells (BSC) in chronic myeloid leukemia and acute lymphoblastic leukemia'. Together they form a unique fingerprint.

Cite this