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Autografting in chronic myeloid leukemia
Angelo M Carella1, Germana Beltrami, Maria T Corsetti
1Department of Hematology/Oncology, IRCCS, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy.
Seminars in Hematology
|February 4, 2003
Summary
Autologous stem cell transplant (ASCT) with interferon alpha and imatinib offers prolonged survival and remission for chronic myeloid leukemia (CML) patients. This approach shows promising results, potentially leading to a cure for those ineligible for conventional allografting.
Area of Science:
- Hematology
- Oncology
Background:
- Autologous stem cell transplant (ASCT) with hematopoietic progenitor cell (HPC) rescue is a viable procedure for prolonged survival in chronic myeloid leukemia (CML) patients.
- Interferon alpha (IFN-alpha) has been used in CML treatment, with imatinib introduced for cytogenetic relapse.
Purpose of the Study:
- To evaluate the efficacy of ASCT combined with interferon alpha (IFN-alpha) and imatinib in CML patients.
- To assess long-term survival and remission rates in patients undergoing this treatment protocol.
Main Methods:
- A cohort of 50 CML patients underwent ASCT followed by IFN-alpha treatment.
- Imatinib was administered for cytogenetic relapse after IFN-alpha therapy.
- Survival and cytogenetic remission rates were monitored.
Main Results:
- 41 out of 50 (82%) patients were alive at a median follow-up of 51 months.
- 56% of patients achieved major cytogenetic remission post-ASCT with IFN-alpha +/- imatinib.
- Outcomes appear superior to IFN-alpha alone and comparable to allografting in younger patients.
Conclusions:
- ASCT combined with IFN-alpha and imatinib demonstrates significant long-term survival and remission in CML patients.
- This integrated approach offers a promising strategy for CML management, especially for patients unsuitable for conventional allografting.
- Further integration of imatinib into ASCT protocols may advance the development of a cure for CML.