High Dose Hydroxyurea in Collection of Philadelphia Chromosome-Negative Stem Cells in Chronic Myeloid Leukaemia
作者:
KussB. J.,
SageR. E.,
ShepherdK. M.,
HardinghamJ.,
NicolaM.,
期刊:
Leukemia&Lymphoma
(Taylor Available online 1993)
卷期:
Volume 10,
issue 1-2
页码: 73-78
ISSN:1042-8194
年代: 1993
DOI:10.3109/10428199309147359
出版商: Taylor&Francis
关键词: Hydroxyurea (HU);chronic myeloid leukaemia (CML);Philadelphia chromosome (Ph);Progenitor cells
数据来源: Taylor
摘要:
High dose hydroxyurea (HU) was used in a pilot study to assess its efficacy in mobilizing Philadelphia (Ph) chromosome negative progenitor cells in chronic myeloid leukaemia (CML). Five patients received 12g/M2oral HU in divided doses. Side effects were minimal, allowing outpatient administration. Nine to fourteen days later 4 patients achieved a mean leukocyte nadir of 3.5×109/L (Range 2.4-4.9) and a mean platelet nadir of 99×109/L (Range 95-108). Peripheral blood mononuclear cells (PB-MNC) sampled prior to the HU priming were 100% Ph positive. Between 10 and 18 days post HU, 3 patients achieved a marked reduction (80-100%) in the number of Ph positive metaphases in PB-MNC collected by apheresis. One patient failed to achieve any Ph suppression. Polymerase chain reaction analysis (PCR) for thebcr-ablfusion product remained positive in all samples.Rapid rises in CFU-GM numbers were associated with a return to 100% Ph positive metaphases however slower rises represented recovery with predominantly Ph negative cells, allowing apheresis collection of these cells.We conclude that HU induces a reproducible leukocyte nadir with sufficient stem cell mobilization for potential autologous transplantation. Higher doses of HU together with early and intensive apheresis is required to maximize Ph negative progenitor cell harvests.
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