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Blood, Vol. 93 No. 5 (March 1), 1999:
pp. 1534-1539
Autografting With Philadelphia Chromosome-Negative Mobilized
Hematopoietic Progenitor Cells in Chronic Myelogenous Leukemia
Angelo M. Carella,
Enrica Lerma,
Maria T. Corsetti,
Anna Dejana,
Palmina Basta,
Franca Vassallo,
Monica Abate,
Monica Soracco,
Federica Benvenuto,
Osvaldo Figari,
Marina Podestà,
Giovanna Piaggio,
Raimondo Ferrara,
Mario Sessarego,
Caterina Parodi,
Michele Pizzuti,
Alessandra Rubagotti,
Domenico Occhini, and
Francesco Frassoni
From the Hematology/ABMT Unit, Department of Hematology, Ospedale San
Martino, Genoa; Biostatistic Unit, Department of Oncology, National
Cancer Institute, University of Genoa; Internal Medicine I, DIMI,
University of Genoa; Cytogenetics, Ospedale San Martino, Genoa; and the
Division of Hematology, Potenza, Italy.
Intensive chemotherapy given in early chronic phase of chronic
myelogenous leukemia (CML) has resulted in high numbers of circulating
Philadelphia (Ph) chromosome-negative hematopoietic progenitor cells
(HPC). We have autografted 30 consecutive patients with CML in chronic
phase with HPC collected in this way to facilitate restoration of
Ph-negative hematopoiesis in bone marrow after high-dose therapy.
Hematopoietic recovery to greater than 0.5 ×109/L
neutrophils and to greater than 25 × 109/L platelets
occurred in all patients, a median of 13 (range, 9 to 32) days and 16 (range, 6 to 106) days postautograft, respectively. Regenerating marrow
cells were Ph-negative in 16 (53%) patients and greater than 66%
Ph-negative in 10 (33%) patients. Twenty-eight patients are alive 6 to
76 months (median, 24 months) after autografting. Three patients have
developed blast crisis from which 2 have died. Eight patients are in
complete cytogenetic remission at a median of 20 (range, 6 to 44)
months with a median ratio BCR-ABL/ABL of 0.002 (range, <0.001 to
0.01). Eight patients are in major cytogenetic remission at a median of
22 (range, 6 to 48) months. No patient died as a consequence of the
treatment. All patients had some degree of stomatitis that was severe
in 15 (50%) patients. Gastrointestinal and hepatic toxicities were
observed in about one fourth of patients. Thus, autografting with
Ph-negative mobilized HPC can result in prolonged restoration of
Ph-negative hematopoiesis for some patients with CML; moreover, most
autograft recipients report normal or near normal activity levels,
suggesting that this procedure need not to be associated either with
prolonged convalescence or with chronic debility.
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