Premium
Autologous marrow transplantation for patients with chronic myelogenous leukemia (CML) in blast crisis
Author(s) -
Thomas M. Roy,
Robinson William A.,
Dantas Mary,
Koeppler Hubert,
Drebing Carla,
Glode L. Michael
Publication year - 1984
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830160202
Subject(s) - medicine , chronic myelogenous leukemia , chemotherapy , bone marrow , surgery , gastroenterology , splenectomy , melphalan , leukemia , transplantation , total body irradiation , cyclophosphamide , spleen
Eleven patients with chronic myelogenous leukemia (CML) in blast crisis were treated with chemotherapy, followed by infusion of autologous bone marrow that had been collected during the chronic phase of the disease and cryopreserved at −198°C. The mean age of the nine females and two males in this study was 34 years with an average duration of the chronic phase of the disease of 5.5 years. Seven out of the 11 patients had a splenectomy prior to intensive chemotherapy. The median survival of the first four patients who received 6‐thioguanine, cytosine arabinoside, daunorubicin (TAD) chemotherapy was 2.6 weeks and no patient reachieved the chronic phase of CML. The second group of seven patients received more intensive chemotherapy (MAdHAT), which included melphalan 30 mg/m 2 days 1, 2, and 3; Adriamycin 50 mg/m 2 intravenously (iv) day 1, hydroxyurea 1500 mg/m 2 by mouth for 5–7 days, cytosine arabinoside 100 mg/m 2 continuous infusion for 5–7 days, and VM‐26 100 mg/m 2 iv on day 3. Six out of these seven patients reachieved chronic phase CML after bone marrow reinfusion. The median survival was 29.9 weeks for all patients and 33 weeks for the six patients who reachieved chronic phase CML. All patients subsequently died of recurrent blast crisis. There was no correlation between the time of bone marrow storage and the duration of subsequent chronic phase CML. These studies have shown that autologous bone marrow transplantation after high‐dose chemotherapy can result in bone marrow engraftment with reestablishment of chronic phase CML, and prolongation of survival.