Autologous Hematopoietic Stem Cell Transplantation in Chronic Myeloid Leukemia with Different Clinical Stages

Abstract

Seven patients with Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) were treated with an ICE-based regimen plus G-CSF with the aim of mobilizing and collecting Ph-negative peripheral stem cells in the setting of an autologous transplant program. Five patients had CML in the first chronic phase and 2 in the accelerated phase. All patients had been previously treated with interferon-α. Median value and ranges for harvested mononuclear cells, CD34+ cells and CFU-GM, respectively: 5.65 × 10⁸/kg (2.61–11.38); 1.48 × 10⁶/kg (0.216–3.5), and 3.43 × 10⁴/kg (0.243–11.6). FISH was the only useful method for detection of minimal residual disease on apheresis product showing <5% t(9;22) positive cells in 2 cases and <10% positive cells in 4 other cases. Four of seven autologous grafts have been transplanted to date. Busulfan conditioning was used in 1 case and TBI/Cy conditioning in 3 other cases. All patients are alive and well following transplantation and are on interferon-α therapy.