Autologous Bone Marrow Transplantation (ABMT) for Patients with Chronic Granulocytic Leukemia (CGL) in Blastic Phase (BP) (original) (raw)

11th Annual meeting of the EBMT, 1985

Abstract

Autologous hemopoietic stem cell infusion after high dose chemo/radiotherapy performed in BP of CGL is able to reinduce II CP in 90% of patients; however the median survival does not last more than 6 months. This report concerns 5 patients with Phl positive CGL in BP treated with BAVC regimen followed by hemopoietic stem cells reinfusion. An intensification program of cyclic chemotherapy has been applied after ABMT with the aim to prolong the survival of these patients. Since 1980 the majority of CGL patients seen at the Institute of Hematology of Rome were subjected to collection and cryopreservation of hemopoietic stem cells from bone marrow (BM) or peripheral blood (PB). Details of the methods have been described elsewhere (1,2). Of the 5 patients presented in this report 4 received stem cells collected from PB and 1 from BM. Four patients were males, median age was 39 years (range 29–41). Therapy during CP consisted of hydroxyurea; no splenectomy had been performed in any patient. Type of transformation was myeloid in 4 cases and mixed in one. BAVC conditioning regimen consisted of BCNU 800 mg/mq day 1; AMSA 150 mg/mq/day on days2–4; VP-16 150 mg/mq/day days 2–4; CA 300 mg/mq/day c.i. days 2–4. Stem cells were reinfused 24 hours after last dose chemotherapy with a median of 11×108(range 3–21) nucleated cells/kg body weight. After complete hematological reconstitution (25–30 days) from autologous infusion an intensification program of cyclic chemotherapy was begun consisting of 3 courses of L-VAMP (VCR 1.5 mg/mq i.v. hour 0,MTX 200mg/mq c.i. hours 1–3,CA 500 mg/mq c.i. hours 3–7, ASNASI 5000 U/mq i.m. hour 24,PDN 40 mg/mq/day days 1–5);3 courses of DAT (DNR 60 mg/mq i.v. day l,CA 60 to 150 mg/mq/8 hours s.c. days 1–5,6-TG 70 mg/mq/8 hours p.o. days 1–5) and 3 courses of HiDAC (CA 1 g/mq/12 hours c.i. in 3 hours on hour 0,12; ASNASI 6000 U/mq i.v. on hour 18).

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