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Mobilization of Philadelphia-negative peripheral blood progenitor cells with chemotherapy and rhuG-CSF in chronic myelogenous leukaemia patients with a poor response to interferon-alpha

Lookup NU author(s): Dr Anne Lennard


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The purpose of this cooperative study was to evaluate the quantity and quality of Phl-negative progenitor cells mobilized in the peripheral blood of patients with chronic myelogenous leukaemia soon after aplasia induced by chemotherapy, 32 patients ineligible for allografting who were cytogenetically refractory to interferon-alpha (IFN-alpha) were entered into this study. The chronic phase varied widely, with a median duration of 17 months (range 3-90 months). All patients were treated with intensive conventional chemotherapy regimens and recombinant human granulocyte colony-stimulating factor (rhuG-CSF, lenograstim). Peripheral blood progenitor cells (PBPC) were harvested by leukaphereses during early recovery from chemotherapy-induced aplasia. A total of 119 leukaphereses were performed. Median numbers of CD34(+) cells and CFU-GM collected were 2.04 x 10(6)/kg and 2.9 x 10(4)/kg, respectively. There was a significant co;relation between white cell count and number of CD34(+) cells in the leukaphereses (P = 0.0001, r(2) = 0.41, n = 104). A strict correlation between the number of CD34(+) cells and CFU-GM in the leukapheretic product (P = 0.0001, r(2) = 0.39. n = 110) was observed, 21% of evaluable patients (6/29) achieved a complete cytogenetic remission in the leukapheretic product and the other four patients achieved a major cytogenetic response for an overall response of 35% (10/22 patients). To date, 16 patients have been autografted and are alive. Five of them are Ph-1-negative (three patients) or partially Ph-1-negative (two patients). In conclusion, despite the high-risk characteristics of this study population, Ph-1-negative PBPC were successfully mobilized in more than one-quarter of patients using a chemotherapy plus rhuG-CSF regimen. The importance of this achievement is increased by the current lack of other practical methods of rescuing Ph-1-negative cells in such patients.

Publication metadata

Author(s): Carella AM, Simonsson B, Link H, Lennard A, Boogaerts M, Gorin NC, Tomas-Martinez JF, Dabouz-Harrouche F, Gautier L, Badri N

Publication type: Article

Publication status: Published

Journal: British Journal of Haematology

Year: 1998

Volume: 101

Issue: 1

Pages: 111-118

Print publication date: 01/04/1998

ISSN (print): 0007-1048

ISSN (electronic): 1365-2141


DOI: 10.1046/j.1365-2141.1998.00670.x


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