Mobilization and transplantation of Philadelphia-negative peripheral- blood progenitor cells early in chronic myelogenous leukemia

A. M. Carella, I. Cunningham, E. Lerma, A. Dejana, F. Benvenuto, M. Podestà, L. Celesti, F. Chimirri, M. Abote, F. Vassallo, O. Figari, C. Parodi, M. Sessarego, M. Valbonesi, P. Carlier, E. Prencipe, A. M. Gatti, D. van den Berg, R. Hoffman, F. Frassoni

Research output: Contribution to journalArticle

Abstract

Purpose: Mobilization of Philadelphia (Ph) chromosome-negative progenitors is now possible in many Ph1-positive chronic myelogenous leukemia (CML) patients who had received interferon alfa (IFN-α) with no cytogenetic response. In this pilot study, we used this approach in patients without prior IFN-α therapy to determine if the number and quality of mobilized progenitors would be increased and to evaluate the potential effect of these cells as autografts. Patients and Methods: Twenty-two untreated patients were mobilized within 12 months of diagnosis. The treatment regimen consisted of the mini-ICE protocol. Beginning on day +8, granulocyte colony- stimulating factor (G-CSF) was used in all patients. Leukophoresis was performed as the patients were recovering from aplasia, when WBC count exceeded 0.8 x 109/L. Results: In 14 patients, (63%) the leukophoresis product was entirely Ph1-negative and in four patients the Ph1-positive cell rate was ≤7%. Significant numbers of long-term culture-initiating cells (LTC-IC) and CD34+ Thy1+Lin- cells were found in most of the Ph1-negative collections that were tested. Twelve patients underwent autografting with their mobilized peripheral-blood progenitor cells (PBPC) (Ph1-negative collections, 10 patients; major cytogenetic response, two patients). All patients engrafted and are olive; six have Ph1-negative marrow 7 to 15 months after autografting. Posttransplant treatment was IFN-α combined with interleukin (IL)-2 because of the recent demonstration of synergistic activity in augmenting cytolytic activity. Conclusion: Intensive chemotherapy given in early chronic phase of CML is well tolerated and results in high numbers of circulating Ph1-negative precursor cells.

Original languageEnglish
Pages (from-to)1575-1582
Number of pages8
JournalJournal of Clinical Oncology
Volume15
Issue number4
Publication statusPublished - Apr 1997

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Carella, A. M., Cunningham, I., Lerma, E., Dejana, A., Benvenuto, F., Podestà, M., Celesti, L., Chimirri, F., Abote, M., Vassallo, F., Figari, O., Parodi, C., Sessarego, M., Valbonesi, M., Carlier, P., Prencipe, E., Gatti, A. M., van den Berg, D., Hoffman, R., & Frassoni, F. (1997). Mobilization and transplantation of Philadelphia-negative peripheral- blood progenitor cells early in chronic myelogenous leukemia. Journal of Clinical Oncology, 15(4), 1575-1582.