¹Service d'Hématologie, Hôpital Edouard Herriot, Lyon, France

²Unité de Cytaphérèses, Centre Léon Bérard, Lyon, France

³Laboratoire d'Hématologie et Cytogénétique, Hôpital Edouard Herriot, Lyon, France

⁴Service d'Hématologie, Hôpital Nord, Saint-Etienne, France

⁵Service d'Hématologie, Centre Hospitalier, Annecy, France

⁶Service de Médecine, Maladies du sang, Centre Hospitalier, Chalon-sur-Saône, France

⁷Service d'Hématologie, Centre Hospitalo-Universitaire Lyon Sud, Lyon, France

⁸Service de Médecins, Maladies du sang, Centre Hospitalier, Valence, France

⁹Service d'Hématologie, Hôpital Robert Debré, Reims, France

¹⁰Service d'Hématologie, Centre Hospitalier, Corbeil-Essone, France

Correspondence to: M Michallet, Unité de Greffe de Cellules Souches Hématopoiétiques, Hôpital Edouard Herriot, 2 Place d'Arsonval, 69437 Lyon, France; Fax: 33 0 4 72 11 74 04

In chronic myelogenous leukemia (CML), autologous stem cell transplantation could be a promising new approach for patients with no cytogenetic response after interferon (IFN-) therapy. We report data on 28 CML patients autotransplanted in chronic phase with peripheral blood progenitor cells mobilized with G-CSF (5 g/kg/day x 5 days) given subcutaneously while continuing IFN- therapy. At mobilization, 23 patients (82%) were in complete hematological remission (CHR), 16 (57%) achieved a minor cytogenetic response (mcr). We obtained, after stimulation, a median of 37.4 ´ 10⁹/l (6.9-108) white blood cells, 7.2 ´ 10⁸/kg (2.2-16.6) mononuclear cells, 39 ´ 10⁴/kg (4.8-403.5) CFU-GM and 4.2 ´ 10⁶/kg (0-58.6) CD34⁺ cells. Six patients received GM-CSF after transplantation. All patients engrafted, with no significant influence stemming from the Sokal index score and pretransplantation IFN- therapy duration. The first cytogenetic evaluation after transplantation showed 11 (39%) major cytogenetic response (Mcr), and nine (32%) mcr with no significant correlation between these responses, the Sokal index score, and pretransplantation IFN- therapy duration, although there was a significant impact from GM-CSF administration (P = 0.01). After transplantation, 26 patients received IFN- alone or associated with hydroxyurea. The median follow-up was 12 months after transplantation and 57 months after diagnosis. At the time of follow-up, nine patients were in CHR, six remained stable in chronic phase, three presented an mcr and one remained in Mcr. At the last follow-up, 22 patients were alive. We conclude that the results of this strategy are encouraging in poor IFN- responders but that other prospective studies that try to maintain the cytogenetic responses obtained immediately after transplantation are needed. Leukemia (2000) 14, 2064-2069.

late autotransplantation; PBPC; G-CSF; IFN-; CML