In these last four decades there has been an extraordinary progress in our understanding on biology and therapeutic approach of chronic myeloid leukemia (CML). During these decades new observations arising from studies of the biologic behaviour of diploid and leukemic stem cells and recently from clinical investigations have received the most attention. From a clinic point of view, allografting is yet the only procedure able to cure CML. For patients without compatible donors, current therapeutic options include conventional chemotherapy (Hydroxyurea), Interferon-alpha (IFN-α) and autografting. While IFN-α must be considered the first line therapy, autografting, according to the Genoa approach or other procedures, rises the question of an ideal sequential strategy in the management of CML patients. Since it seems that diploid hematopoietic reservoir declines with time, it may be desiderable to mobilize and collect diploid stem cells in order to store them as soon as diagnosis at possible when the WBC count has been controlled by Hydroyurea while searching for a MUD is proceeding. Then six months should be allowed for a MUD search. If the donor is not found, the patient may undergo autografting with the previously stored Ph-negative progenitors followed by IFN-α therapy. Of course, this is an experimental procedure and should be employed only in highly selected centers.
|Translated title of the contribution||Mobilization and transplantation of Philadelphia-negative peripheral blood progenitor cells in chronic myeloid leukemia|
|Number of pages||7|
|Publication status||Published - 1998|
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