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Chronic Myeloid Leukemia

Molecular remission of CML after autotransplantation followed by adoptive transfer of costimulated autologous T cells

Bone Marrow Transplantation volume 33, pages 53–60 (2004)Cite this article

Summary:

Four patients with chronic myelogenous leukemia (CML) that was refractory to interferon alpha (two patients) or imatinib mesylate (two patients), and who lacked donors for allogeneic stem cell transplantation, received autotransplants followed by infusions of ex vivo costimulated autologous T cells. At day +30 (about 14 days after T-cell infusion), the mean CD4+ cell count was 481 cells/μl (range 270–834) and the mean CD8+ count was 516 cells/μl (range 173–1261). One patient had a relative lymphocytosis at 3.5 months after T-cell infusion, with CD4 and CD8 levels of 750 and 1985 cells/μl, respectively. All the four patients had complete cytogenetic remissions early after transplantation, three of whom also became PCR negative for the bcr/abl fusion mRNA. One patient, who had experienced progressive CML while on interferon alpha therapy, became PCR− post transplant, and remained in a molecular CR at 3.0 years of follow-up. All the four patients survived at 6, 9, 40, and 44 months post transplant; the patient who remained PCR+ had a cytogenetic and hematologic relapse of CML, but entered a molecular remission on imatinib. Autotransplantation followed by costimulated autologous T cells is feasible for patients with chronic phase CML, who lack allogeneic donors and can be associated with molecular remissions.

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Acknowledgements

Aaron P Rapoport is a Clinical Scholar of the Leukemia and Lymphoma Society. Partial support for this work came from an Institutional Grant (#IRG97-153-01) awarded by the American Cancer Society, an unrestricted grant from Immunex Corporation, and by Leukemia and Lymphoma Society SCOR grant #7000-02. We would like to acknowledge the excellent care provided to these patients by the clinical nurses, nurse practitioners, and nurse coordinators of the Greenebaum Cancer Center Stem Cell Transplant Program and the outstanding laboratory support by Julio Cotte, Zhoohui Zheng and Brian Gregson at the Clinical Cell and Vaccine Production Facility of the Abramson Family Cancer Research Institute at the University of Pennsylvania Cancer Center. Also, we thank Dr Metin Ozdemirli (Georgetown University) for providing the PCR results. Finally, we gratefully acknowledge the expert assistance of Michele Mullins in the preparation of the manuscript.

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Authors and Affiliations

  1. Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA

    A P Rapoport, A Badros, B Meisenberg, K Ruehle, A Nandi, S Rollins, S Natt, B Ratterree, S Westphal & D Mann

  2. University of Pennsylvania, Abramson Family Cancer Research Institute at the University of Pennsylvania Cancer Center, Philadelphia, PA, USA

    B L Levine & C H June

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Rapoport, A., Levine, B., Badros, A. et al. Molecular remission of CML after autotransplantation followed by adoptive transfer of costimulated autologous T cells. Bone Marrow Transplant 33, 53–60 (2004). https://doi.org/10.1038/sj.bmt.1704317

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