Late autologous transplantation in chronic myelogenous leukemia with peripheral blood progenitor cells mobilized by G-CSF and interferon-α

被引:6
作者
Michallet, M
Thiébaut, A
Philip, I
Charrin, C
Vigouroux, C
Thomas, X
Bilger, K
Belhabri, A
Guyotat, D
Corront, B
Salles, B
Dumontet, C
Peaud, PY
Vilque, JP
Devidas, A
Fière, D
机构
[1] Hop Edouard Herriot, Unite Greffe Cellules Souches Hematopoiet, Serv Hematol, F-69437 Lyon, France
[2] Ctr Leon Berard, Unite Cytaphereses, F-69373 Lyon, France
[3] Hop Edouard Herriot, Lab Hematol & Cytogenet, F-69437 Lyon, France
[4] Hop Nord St Etienne, Serv Hematol, St Etienne, France
[5] Ctr Hosp, Annecy, France
[6] Ctr Hosp, Serv Med Malad Sang, Chalon sur Saone, France
[7] Univ Lyon, Serv Hematol, Ctr Hosp Lyon Sud, Lyon, France
[8] Ctr Hosp, Med Serv, Valence, France
[9] Hop Robert Debre, Serv Hematol, Reims, France
[10] Ctr Hosp, Serv Hematol, Corbeil Essonnes, France
关键词
late autotransplantation; PBPC; G-CSF; IFN-alpha; CML;
D O I
10.1038/sj.leu.2401956
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In chronic myelogenous leukemia (CML), autologous stem cell transplantation could be a promising new approach for patients with no cytogenetic response after interferon- alpha (IFN-alpha) therapy. We report data on 28 CML patients autotransplanted in chronic phase with peripheral blood progenitor cells mobilized with GCSF (5 mug/kg/day x 5 days) given subcutaneously while continuing IFN-alpha therapy. At mobilization, 23 patients (82%) were in complete hematological remission (CHR), 16 (57%) achieved a minor cytogenetic response (mcr). We obtained, after stimulation, a median of 37.4x10(9)/l (6.9-108) white blood cells, 7.2x10(8)/kg (2.2-16.6) mononuclear cells, 39x10(4)/kg (4.8-403.5) CFU-GM and 4.2x10(6)/kg (0-58.6) CD34(+) cells. Six patients received GM-CSF after transplantation. All patients engrafted, with no significant influence stemming from the Sokal index score and pretransplantation IFN-alpha therapy duration. The first cytogenetic evaluation after transplantation showed 11 (39%) major cytogenetic response (Mcr), and nine (32%) mcr with no significant correlation between these responses, the Sokal index score, and pretransplantation IFN-alpha therapy duration, although there was a significant impact from GM-CSF administration (P=0.01). After transplantation, 26 patients received IFN-alpha alone or associated with hydroxyurea. The median follow-up was 12 months after transplantation and 57 months after diagnosis. At the time of follow-up, nine patients were in CHR, six remained stable in chronic phase, three presented an mcr and one remained in Mcr. At the last follow-up, 22 patients were alive. We conclude that the results of this strategy are encouraging in poor IFN-alpha responders but that other prospective studies that try to maintain the cytogenetic responses obtained immediately after transplantation are needed.
引用
收藏
页码:2064 / 2069
页数:6
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