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• W2156236017 abstract "19 To the editor: Chronic myelogenous leukemia (CML) is only curable with allogeneic stem cell transplant (AlloSCT) (1–5). Allo-SCT is usually limited to patients less than 50–55 years of age, and because only a small number of patients have a compatible sibling, the treatment becomes available only to approximately 25% of all patients. The coexistence of normal and malignant progenitor cells in the bone marrow of some CML patients has been described (6,7), and the possibility of obtaining normal diploid cells after intensive chemotherapy-induced marrow aplasia is possible, even in patients with advanced CML refractory to interferon therapy (8). We report 3 Ph1 CML patients in which we attempted to obtain ABL-BCR fusion-gene expression-free cells for transplantation. The patients were all in the first chronic phase and were ineligible for allogeneic bone marrow transplant; all gave written informed consent. Mobilizations were done using 800 mg of Ara-c intravenously twice a day for 3 consecutive days, and 3 days of intravenous idarubicin (12 mg/m2/per day). Subcutaneous granulocyte colonystimulating factor (G-CSF) (Neupogen HoffmannLaRoche) at 10 mg/kg was started the first day after mobilization chemotherapy as a single-dose subcutaneous application, until the last apheresis procedure. Cells were harvested by apheresis using a Baxter CS3000 cell processor following eight standard baseline cell collection programs. The aim of the harvest was to obtain 2.5 3 108 mononuclear cells/kg. Harvesting occurred when patients had 2,000 or more WBC/ml. Detection of ABL-BCR transcripts was done by “multiplex” and “nested” (9,10). The percentage of CD341 cells was obtained by standard flow cytometry (11). Case 1. The patient was a 19-year-old male who received hydroxiurea and then interferon-a2a for 7 months. Ten months after being diagnosed, the patient underwent PBSC mobilization. The harvest was started when the WBC count was 2,400/ml. Four apheresis procedures were performed on days 122, 123, 124, and 125 at the end of mobilization chemotherapy. Case 2. The patient was a 29-year-old male who received two courses of high-dose chemotherapy with araC and epirubicin. The patient received interferon-a2a for 4 months. Six months after diagnosis, the patient underwent mobilization. Harvest was started with a WBC count 6,400/ml. Three apheresis procedures were performed. Case 3. This 35-year-old received hydroxyurea and then interferon-a2a for 8 months. One year after the diagnosis, the patient underwent PBSC mobilization. Harvest was started when the leukocyte count was 2,700/ml. Results of all the apheresis procedures, including the number of mononuclear and CD341 cells, as well as results of ABL-BCR testing, are shown on Table 1. The relapse after autologous transplant can be explained the persistance of malignant cells in the patient’s body, the “reinfusion” of malignant cells in the transplant inoculum, or both (12). Autografting Ph-negative cells in CML patients is a very exciting possibility. There have been reports of both complete and partial Ph-negative PBSC harvests in CML patients after intermediate and" @default.
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• W2156236017 date "2001-02-01" @default.
• W2156236017 modified "2023-10-01" @default.
• W2156236017 title "In Vivo Purging of Peripheral Blood Stem Cells Obtained by Apheresis, Using High-Dose Chemotherapy and Granulocyte Colony-Stimulating Factor in Chronic Myelogenous Leukemia Patients" @default.
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• W2156236017 doi "https://doi.org/10.1089/152581601750098156" @default.
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