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High‐dose cyclophosphamide for mobilization of circulating stem cells in chronic myeloid leukemia
Author(s) -
Tringali Stefania,
Santoro Alessandra,
Scimé Rosanna,
Vasta Stefania,
Pampinella Maria,
Marino Maria Assunta,
Majolino Ignazio
Publication year - 1994
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1994.tb00170.x
Subject(s) - cyclophosphamide , medicine , melphalan , bone marrow , myeloid leukemia , haematopoiesis , stem cell , clone (java method) , chemotherapy , progenitor cell , apheresis , myeloid , immunology , cancer research , platelet , biology , dna , genetics
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/m 2 ) cyclophosphamide (HD‐CY) mobilization. All were autografted, using busulphan 16 mg/kg and melphalan 60 mg/m 2 . 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.