Abstract
High-dose chemotherapy with autologous transplantation of in vivo purged PBSC is a new and interesting therapeutic option for CML patients not eligible for allogeneic transplantation. We investigated the feasibility and toxicity of this approach in 57 patients with Ph-positive CML. For mobilization of Ph-negative PBSC, patients were treated either with ‘5 + 2/7 + 3’-type chemotherapy or with ‘mini-ICE/ICE’ chemotherapy followed by administration of G-CSF. Fourteen patients were in early chronic phase, 30 patients in late chronic phase and 13 patients in accelerated phase (AP) or blast crisis (BC). Cytogenetic responses in the PBSC harvests were dependent on both disease stage and type of chemotherapy: in late chronic phase and AP/BC, a complete or major cytogenetic response could be obtained in nine out of 13 patients treated with ‘mini-ICE/ICE’ but only in three out of 23 patients treated with ‘5 + 2/7 + 3’ chemotherapy. However, in early chronic phase a Ph-negative autograft could be obtained in three out of eight patients upon mobilization with ‘5 + 2’ chemotherapy. Thirty-one patients underwent PBSC transplantation and all of them successfully engrafted. Post-transplant cytogenetic analysis was available on 21 cases, of whom seven achieved a complete or major cytogenetic response, with two minor cytogenetic remissions. One patient (1/57) in blast crisis died during mobilization therapy (1.8%). Transplantation related mortality was 0%. This study demonstrates that mobilization of Ph-negative PBSC after myelosuppressive chemotherapy is feasible in CML patients and is associated with acceptable toxicity. Autologous transplantation of in vivo purged PBSC is a safe procedure with rapid and complete hematopietic recovery.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fischer, T., Neubauer, A., Mohm, J. et al. Chemotherapy-induced mobilization of karyotypically normal PBSC for autografting in CML. Bone Marrow Transplant 21, 1029–1036 (1998). https://doi.org/10.1038/sj.bmt.1701229
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1701229
Keywords
This article is cited by
-
BCR/ABL regulates response to DNA damage: the role in resistance to genotoxic treatment and in genomic instability
Oncogene (2002)
-
Safety and efficacy of STI-571 (imatinib mesylate) in patients with bcr/abl-positive chronic myelogenous leukemia (CML) after autologous peripheral blood stem cell transplantation (PBSCT)
Leukemia (2002)
-
Donation of stem cells from blood or bone marrow: results of a randomised study of safety and complaints
Bone Marrow Transplantation (2002)
-
Chemotherapy for mobilisation of Ph-negative progenitor cells from patients with CML: impact of different mobilisation regimens
Bone Marrow Transplantation (2001)
-
Autografting with non-clonal mobilized hematopoietic progenitor cells in CML
Leukemia (2000)