Autologous transplant for chronic myelogenous leukemia using marrow treated ex vivo with mafosfamide
| Autor: | Carlo-Stella, C., Mangoni, L., Camillo Almici, Caramatti, C., Cottafavi, L., Dotti, G. P., Rizzoli, V. |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Male Bone Marrow Purging Hematopoietic Stem Cell Transplantation Pilot Projects Middle Aged Hematopoietic Stem Cells Transplantation Autologous Survival Rate Bone Marrow Karyotyping Leukemia Myelogenous Chronic BCR-ABL Positive Chronic Disease Humans Female Cyclophosphamide Bone Marrow Transplantation Follow-Up Studies |
| Zdroj: | Scopus-Elsevier Europe PubMed Central |
| ISSN: | 0268-3369 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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