Abstract
In chronic myelogenous leukemia (CML), autologous stem cell transplantation could be a promising new approach for patients with no cytogenetic response after interferon α (IFN-α) therapy. We report data on 28 CML patients autotransplanted in chronic phase with peripheral blood progenitor cells mobilized with G-CSF (5 μg/kg/day x 5 days) given subcutaneously while continuing IFN-α 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-α 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-α therapy duration, although there was a significant impact from GM-CSF administration (P = 0.01). After transplantation, 26 patients received IFN-α 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-α responders but that other prospective studies that try to maintain the cytogenetic responses obtained immediately after transplantation are needed.
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Michallet, M., Thiébaut, A., Philip, I. et al. Late autologous transplantation in chronic myelogenous leukemia with peripheral blood progenitor cells mobilized by G-CSF and interferon-α. Leukemia 14, 2064–2069 (2000). https://doi.org/10.1038/sj.leu.2401956
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DOI: https://doi.org/10.1038/sj.leu.2401956