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Marrow transplantation for stable-phase chronic granulocytic leukemia
Insights
Bone marrow transplantation can eliminate Philadelphia chromosome-positive cells in chronic granulocytic leukemia patients. This procedure offers a relatively safe and effective treatment option for stable-phase disease.
Area of Science:
- Hematology
- Oncology
- Transplantation Medicine
Background:
- Chronic granulocytic leukemia (CGL) is characterized by the Philadelphia chromosome.
- Stable-phase CGL patients represent a unique group for therapeutic interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of bone marrow transplantation (BMT) in stable-phase CGL.
- To assess the elimination of the abnormal myeloid clone post-BMT.
Main Methods:
- Ten patients with stable-phase CGL received BMT from HLA-identical siblings or an identical twin.
- Conditioning regimen included cytarabine, cyclophosphamide, and total body irradiation.
- Marrow cytogenetics were analyzed pre- and post-transplantation.
Main Results:
- All patients achieved cytogenetically normal marrow post-transplantation.
- Leukemia recurrence was observed only in the syngeneic transplant recipient.
- Nine out of ten patients survived long-term (median 597 days).
Conclusions:
- BMT effectively eradicates the abnormal myeloid clone in stable-phase CGL.
- BMT is a relatively safe and curative option for this patient population.
Abstract:
Ten patients with chronic granulocytic leukemia in the stable phase underwent marrow transplantation from HLA-identical siblings (nine cases) or an identical twin (one case) following preparation with cytarabine, cyclophosphamide, and total body irradiation. Marrow cytogenetics on all patients prior to transplantation revealed the Philadelphia chromosome without other evidence of aneuploidy. The immediate posttransplant course was in most cases relatively uncomplicated with only two serious infections and one death. All patients recovered with cytogentically normal marrow and leukemia has recurred only in the syngeneic transplant recipient. At present, nine patients are surviving from 358 to 961 days (median 597 days) after bone marrow transplantation. Bone marrow transplantation is capable of eliminating the abnormal clone of myeloid cells in patients with stable-phase chronic granulocytic leukemia and can be performed relatively safely in this "healthy" group of patients.