Clinical models of autotransplants in chronic myelogenous leukemia

We analysed relapse risk after syngeneic and allogeneic T cell depleted transplants to predict the outcome after autotransplants in chronic myelogenous leukemia (CML). These data suggest that high dose pre-transplant conditioning may cure about 50% of the persons in chronic phase and about 10% of those in more advanced phases. The expected relapse rate would be about 50-90%. However, additional relapses might occur from infusing leukemia cells with the graft. Different approaches are being attempted to eliminate leukemia cells from the graft. It is however unlikely that their effect could be demonstrated in clinical trials. Recent analyses in persons relapsing after allogeneic T depleted transplants suggest that reducing the CML cell mass by high dose chemotherapy may prolong duration of survival.