Mobilization of Cytogenetically‘Normal’Blood Progenitors Cells by Intensive Conventional Chemotherapy for Chronic Myeloid and Acute Lymphoblastic Leukemia
作者:
CarellaA. M.,
PollicardoN.,
PungolinoE.,
RaffoM. R.,
PodestaM.,
FerreroR.,
PierluigiD.,
NatiS.,
NaiboK.,
CongiuA.,
SprianoM.,
VimercatiR.,
FigariO.,
RossoC.,
SaglioG.,
SessaregoM.,
LercariG.,
ValbonesiM.,
CarlierP.,
VitaleV.,
CorvoP.,
ParodiM.,
期刊:
Leukemia&Lymphoma
(Taylor Available online 1993)
卷期:
Volume 9,
issue 6
页码: 477-483
ISSN:1042-8194
年代: 1993
DOI:10.3109/10428199309145754
出版商: Taylor&Francis
关键词: Mobilization;blood progenitor cells;chemotherapy;chronic myeloid leukemia and acute lymphoblastic leukemia
数据来源: Taylor
摘要:
Various lines of evidence suggest that substantial numbers of very primitive normal hematopoietic cells persist in the marrow of most patients with CML, despite the presence of an expanded Philadelphia-Chromosome (Ph) positive population, and that normal clones might, in certain circumstances, have a proliferative advantage over leukemic populations. We have recently demonstrated in 5/8 CML patients with blastic phase (BP) that the blood progenitor cells/(BPC) harvested during early recovery from marrow aplasia were Ph-negative on cytogenetic analysis, suggesting that leukapheresis may provide a useful source of 'normal' progenitors for subsequent reinfusions. We report here an update on 40 patients with Ph + CML and 9 patients with ALL in first or subsequent relapses with associated cytogenetic translocations including t(8;14) t(4;8) t(4;11) and t(9;22). All these patients received intensive conventional chemotherapy and during early recovery from marrow aplasia, when the WBC reached 0.5–2.0×109/L, BPC were collected by 4–8 leukapheresis and tested for the persistence of the marker translocations and, when possible, for the presence of the hybrid bcr/abl transcripts by polymerase chain reaction (PCR). In seven out of 10 patients with chronic phase CML, BPC were Ph-negative and in 5 PCR negative. In both accelerated phase patients, BPC were Ph-negative but PCR-positive and in eight out of 28 blastic CML patients, BPC were Ph-negative and in two cases also PCR-negative. Six out of 9 ALL patients, lost the cytogenetic translocations. After complete recovery, 16 patients were subsequently given high-dose therapy followed by reinfusion of 'normal' BPC. Two patients in CP-CML and 2 out of six patients with ALL maintain clinical and cytogenetic remission at 3 and 10 months and 16 months respectively. All the patients transplanted in BP-CML relapsed 5–18 months post-transplant. These data suggest that intensive conventional chemotherapy can lead to a precocious overshoot of cytogenetically normal BPC.
点击下载:
PDF (525KB)
返 回