Faculty Collaboration Database

Successful autologous stem cell collection in patients with chronic myeloid leukemia in complete cytogenetic response, with quantitative measurement of BCR-ABL expression in blood, marrow, and apheresis products. Leuk Lymphoma 2008 Mar;49(3):531-7

Date

02/26/2008

Pubmed ID

18297531

DOI

10.1080/10428190701799043

Scopus ID

2-s2.0-39749131562 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

Imatinib mesylate is the initial therapy of choice for chronic myeloid leukemia in chronic phase (CML-CP), but in some patients, the disease becomes resistant to imatinib. Autologous stem cell transplantation using cells collected while in complete cytogenetic response (CCyR) may represent a therapeutic option for these patients. We mobilized and collected autologous CD34(+) stem cells from 20 CML-CP patients in CCyR, 19 of whom were taking imatinib, and measured BCR-ABL expression in the apheresis products, blood and bone marrow using real-time quantitative PCR (RQ-PCR). Stem cells were mobilized with G-CSF 10 microg/kg daily for 5 days. In patients whose initial collection was <2x10(6) CD34(+) cells/kg, G-CSF dose was increased to 10 microg/kg twice daily on the second attempt, and imatinib was held for 14 days if a third attempt was necessary. All 20 patients successfully mobilized the target yield of 2 to 5x10(6) CD34(+) cells/kg; 16 reached target yield with the first mobilization. The median number of CD34(+) cells collected was 4.4 (range, 2.0 - 8.4)x10(6)/kg in a median of 3 (range, 2 - 6) apheresis days. Of 17 patients whose stem cell products were evaluable by RQ-PCR, 11 (65%) had >or=1 daily product with undetectable BCR-ABL; 4 of these (24%) had no detectable BCR-ABL in any apheresis products. BCR-ABL expression in apheresis products was correlated with levels of expression in the blood and marrow prior to mobilization. No patient has yet required transplantation. With median follow-up of 18 months, all patients remain in CCyR and 9 of 16 (54%) have undetectable BCR-ABL in the most recent blood and marrow sample.

Author List

Gordon MK, Sher D, Karrison T, Kebriaei P, Chuang K, Zhang Y, McDonnell D, Artz A, Godley L, Odenike O, Rich E, Michaelis L, Thirman MJ, Wickrema A, van Besien K, Larson RA, Stock W

Author

Laura Michaelis MD Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Antigens, CD34
Benzamides
Blood Component Removal
Bone Marrow
Cytogenetic Analysis
Female
Filgrastim
Fusion Proteins, bcr-abl
Granulocyte Colony-Stimulating Factor
Hematopoietic Stem Cell Mobilization
Humans
Imatinib Mesylate
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Male
Middle Aged
Piperazines
Pyrimidines
Recombinant Proteins
Remission Induction
Transplantation, Autologous
Treatment Outcome