Autologous transplant for chronic myelogenous leukemia using marrow treated ex vivo with mafosfamide.
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| Abstract |
Ten adult patients with Ph-positive chronic myelogenous leukemia (CML) received autologous transplantation using marrow treated ex vivo with mafosfamide. At transplant, 7 patients were in chronic phase (5 in first, 2 in second) and 3 in accelerated phase. The median time to achieve 500 x 10(6)/l neutrophils was 32 days (range 17-72 days). A platelet count of 20 x 10(9)/l was achieved at a median of 40 days (range 24-151 days). After transplant, cytogenetic analysis revealed 100% Ph-negative marrow metaphases in 6 of 9 analyzable patients with a median duration of Ph-negative hematopoiesis of 6.5 months. After a median follow-up of 16 months (range 3-31 months), five patients evolved into blast crisis, two died of non-hematological causes, one is Ph-negative in chronic phase at +4 and one is in chronic phase, but Ph-positive, at +22. In conclusion, this pilot study demonstrates that: (1) engraftment can occur from Ph-negative stem cells selected by mafosfamide, (2) mafosfamide purging may induce a transient period of Ph-negative hematopoiesis, and (3) modifications of the purging procedure and post-transplant manipulations of the immune-hematopoietic system are required to prolong cytogenetic remission.
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| Authors | C Carlo-Stella, L Mangoni, C Almici, C Caramatti, L Cottafavi, G P Dotti, V Rizzoli |
| Journal | Bone marrow transplantation (Bone Marrow Transplant) Vol. 14 Issue 3 Pg. 425-32 (Sep 1994) ISSN: 0268-3369 [Print] England |
| PMID | 7994267 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't) |
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