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Revista Brasileira de Hematologia e Hemoterapia
On-line version ISSN 1806-0870
CARVALHO, Paulo V. B. et al. Autografting of peripheral-blood progenitor cells early in chronic myeloid Leukemia. Rev. Bras. Hematol. Hemoter. [online]. 2004, vol.26, n.4, pp. 256-262. ISSN 1806-0870. http://dx.doi.org/10.1590/S1516-84842004000400005.
The role of peripheral-blood progenitor cell (PBPC) transplantation as a treatment for chronic myeloid leukemia (CML) patients remains uncertain. We presented herein 11 CML patients treated with autografting of PBPC in early chronic phase followed by interferon-alpha (IFN-a). Bone marrow samples obtained at diagnosis and during follow-up after autografting as well as leukapheresis products were analyzed by cytogenetics, fluorescence in situ hybridization (FISH) and reverse transcriptase-polymerase chain reaction (RT-PCR). The median follow-up of patients after autografting was 22 months (range: 1-49). Two treatment-related deaths occurred in patients enrolled in the study. Eight out of 9 (88.9%) and 7 out of 9 (77.8%) patients achieved hematologic and cytogenetic responses, respectively. Molecular cytogenetic and molecular responses were seen in all 7 patients analyzed (100.0%) and in one single patient (11.1%), respectively. The median percentages of Ph+ (78.0%) metaphases obtained after 6 months of autografting was lower than those obtained at diagnosis (100.0%, P=0.04). The median percentages of FISH+ nuclei obtained at 3 (4.0%), 6 (7.3%) and 9 (14.7%) months after autografting were also lower than that obtained at diagnosis (82.5%; P=0.002; P=0.003; P=0.030, respectively). At the end of the study, 9 patients (81.8%) were alive in chronic phase, 4 of them presenting hematologic, cytogenetic and molecular cytogenetic responses. We conclude that autografting performed with PBPC in early chronic phase of CML followed by IFN-a results in lower numbers of Ph+ and FISH+ cells in bone marrow.
Keywords : Chronic myeloid leukemia; autografting; interferon-alpha; cytogenetic; FISH; RT-PCR.