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High-dose cyclophosphamide for mobilization of circulating stem cells in chronic myeloid leukemia

Authors :
Maria Pampinella
Rosanna Scimè
Ignazio Majolino
Stefania Tringali
Vasta S
Alessandra Santoro
Maria Assunta Marino
Source :
European Journal of Haematology. 53:1-5
Publication Year :
2009
Publisher :
Wiley, 2009.

Abstract

Experimental and clinical data suggest that Ph-negative myeloid progenitor cells are present, albeit suppressed, in the bone marrow of chronic myeloid leukemia (CML) patients. These residual Ph-negative cells might, in certain circumstances, regain their proliferative advantage over the leukemic Ph-positive clone. Treating CML patients with intensive chemotherapy might allow the harvest, in the early phase of recovery, of Ph-negative stem cells to be used as graft after myeloablative regimen. In our study, 6 CML patients were admitted to a program of autograft with circulating stem cells (CSC) collected after high-dose (5 or 7 g/m2) cyclophosphamide (HD-CY) mobilization. All were autografted, using busulphan 16 mg/kg and melphalan 60 mg/m2. As graft, 4 patients received CSC only, while 2 patients were also given bone marrow, as their peripheral blood CFU-GM yield was unsatisfactory. Two previously alpha-IFN-responding patients showed a slow hematologic recovery, but achieved a marked and further reduction of their Ph-positive metaphases post-graft. Moreover, in one of them, cytogenetic analyses performed on apheresis product showed a more pronounced reduction of his Ph-positive metaphases, as compared to bone marrow samples, suggesting a potential purging effect of the mobilization procedure.

Details

ISSN :
16000609 and 09024441
Volume :
53
Database :
OpenAIRE
Journal :
European Journal of Haematology
Accession number :
edsair.doi.dedup.....71cca2cf04ee9793f990b0f8fe10ce98