Therapy of Acute-Phase Chronic Myelogenous Leukemia with Intensive Chemotherapy, Blood Cell Autotransplantation and Cyclosporine A

1992 ◽  
pp. 522-528
Author(s):  
A. M. Carella
Keyword(s):  
Blood Cell ◽  
Chronic Myelogenous Leukemia ◽  
Acute Phase ◽  
Cyclosporine A ◽  
Myelogenous Leukemia ◽  
Intensive Chemotherapy

BCR/ABL− CD34+HLA-DR−Progenitor Cells in Early Chronic Phase, But Not in More Advanced Phases, of Chronic Myelogenous Leukemia Are Polyclonal

Blood ◽  
1999 ◽  
Vol 93 (1) ◽  
pp. 284-292 ◽  
Author(s):  
Michel Delforge ◽  
Marc A. Boogaerts ◽  
Philip B. McGlave ◽  
Catherine M. Verfaillie
Keyword(s):  
Steady State ◽  
Progenitor Cells ◽  
Chronic Myelogenous Leukemia ◽  
X Chromosome ◽  
Chronic Phase ◽  
X Chromosome Inactivation ◽  
Myelogenous Leukemia ◽  
Chromosome Inactivation ◽  
Intensive Chemotherapy ◽  
Hla Dr

Abstract Chronic myelogenous leukemia (CML) is characterized by the Philadelphia (Ph) translocation and BCR/ABL gene rearrangement which occur in a pluripotent hematopoietic progenitor cell. Ph-negative (Ph−) hematopoiesis can be restored in vivo after treatment with -interferon or intensive chemotherapy, suggesting that normal stem and progenitor cells coexist with the Ph+ clone. We have previously shown that Ph− progenitors are highly enriched in the CD34+HLA-DR− fraction from early chronic phase (ECP) CML patients. Previous studies have suggested that the Ph-translocation represents a secondary clonal hit occurring in an already clonally mutated Ph− progenitor or stem cells, leaving the unanswered question whether Ph−CD34+HLA-DR- progenitors are normal. To show the clonal nature of Ph−CD34+HLA-DR− CML progenitors, we have compared the expression of BCR/ABL mRNA with X-chromosome inactivation patterns (HUMARA) in mononuclear cells and in CD34+HLA-DR+ and CD34+HLA-DR− progenitors in marrow and blood obtained from 11 female CML patients (8 in chronic phase and 3 in accelerated phase [AP] disease). Steady-state marrow-derived BCR/ABL mRNA−, CD34+HLA-DR−progenitors had polyclonal X-chromosome inactivation patterns in 2 of 2 patients. The same polyclonal pattern was found in the progeny of CD34+HLA-DR− derived long-term culture-initiating cells. Mobilization with intensive chemotherapy induced a Ph−, BCR/ABL mRNA−and polyclonal state in the CD34+HLA-DR−and CD34+HLA-DR+ progenitors from 2 ECP patients. In a third ECP patient, polyclonal CD34+ cells could only be found in the first peripheral blood collection. In contrast to ECP CML, steady-state marrow progenitors in late chronic phase and AP disease were mostly Ph+, BCR/ABL mRNA+, and clonal. Further, in the majority of these patients, a Ph−, polyclonal state could not be restored despite mobilization with intensive chemotherapy. We conclude from these studies that CD34+HLA-DR− cells that are Ph− and BCR/ABL mRNA− are polyclonal and therefore benign. This population is suitable for autografting in CML.

The value of intensive combination chemotherapy for juvenile chronic myelogenous leukemia.

1987 ◽  
Vol 5 (12) ◽  
pp. 1960-1967 ◽  
Author(s):  
H S Chan ◽  
Z Estrov ◽  
S S Weitzman ◽  
M H Freedman
Keyword(s):  
Quality Of Life ◽  
Chronic Myelogenous Leukemia ◽  
Combination Chemotherapy ◽  
Clinical Remission ◽  
Clinical Status ◽  
Myelogenous Leukemia ◽  
Intensive Chemotherapy ◽  
Acute Nonlymphoblastic Leukemia ◽  
Better Than

Nine children with juvenile chronic myelogenous leukemia (JCML) were diagnosed in an 8-year period from 1977 to 1984. The clinical courses and outcomes of five patients who received minimal or no chemotherapy were compared with that of four patients who were treated with intensive acute nonlymphoblastic leukemia (ANLL) combination chemotherapy. None of the five patients in the former group achieved clinical remission and their survivals were 1, 4, 4, 7, and 29 months, respectively. All four patients in the latter group achieved clinical remissions that lasted 11, 21, 21, and 27 + months, respectively. The durations of their survival (21, 26, 30, and 32 + months) were significantly better than the five patients who received minimal or no chemotherapy (P less than .05). Despite hospitalizations for chemotherapy and for treatment of chemotherapy-associated complications, the clinical status and quality of life of the children who achieved clinical remission were superior to those who remained in relapse. Although intensive chemotherapy induced lengthy remissions, three of the four patients have relapsed. Cytogenetic and cell culture data indicated that the monocytic-macrophage cells characteristic of JCML appeared to be suppressed during remission rather than totally eliminated. We recommend that ANLL-type combination chemotherapy be used as the initial treatment of JCML because of its promptness in effecting clinical remissions. Improved maintenance and consolidation protocols have to be developed to produce durable remissions and cures. Alternatively, bone marrow transplantation may be a useful option soon after remission is achieved with chemotherapy.

Successful mobilization of Ph-negative blood stem cells with intensive chemotherapy + G-CSF in patients with chronic myelogenous leukemia in first chronic phase

2006 ◽  
Vol 47 (9) ◽  
pp. 1768-1773 ◽  
Author(s):  
Ulla Olsson-Strömberg ◽  
Martin Höglund ◽  
Magnus Björkholm ◽  
Inger Braide ◽  
Karin Carlson ◽  
...  
Keyword(s):  
Stem Cells ◽  
Chronic Myelogenous Leukemia ◽  
Chronic Phase ◽  
Myelogenous Leukemia ◽  
Intensive Chemotherapy ◽  
Blood Stem Cells

Intensive Chemotherapy with Interferon for Induction of True Remission in Chronic Phase of Chronic Myelogenous Leukemia

1990 ◽  
Vol 8 (2) ◽  
pp. 303-304
Author(s):  
Zalmen Arlin ◽  
E. Feldman ◽  
T. Ahmed ◽  
A. Mittelman ◽  
C. Puccio ◽  
...  
Keyword(s):  
Chronic Myelogenous Leukemia ◽  
Chronic Phase ◽  
Myelogenous Leukemia ◽  
Intensive Chemotherapy

Chromosome changes in a patient achieving complete remission in the acute phase of chronic myelogenous leukemia

1979 ◽  
Vol 6 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Ronald Stern ◽  
Julie Sorenson ◽  
Doris H. Wurster-Hill ◽  
Gibbons G. Cornwell ◽  
O. Ross McIntyre
Keyword(s):  
Complete Remission ◽  
Chronic Myelogenous Leukemia ◽  
Acute Phase ◽  
Myelogenous Leukemia

Collection of peripheral-blood diploid cells from chronic myelogenous leukemia patients early in the recovery phase from myelosuppression induced by intensive-dose chemotherapy.

1995 ◽  
Vol 13 (3) ◽  
pp. 553-559 ◽  
Author(s):  
H M Kantarjian ◽  
M Talpaz ◽  
J Hester ◽  
E Feldman ◽  
M Korbling ◽  
...  
Keyword(s):  
Stem Cell ◽  
Chronic Myelogenous Leukemia ◽  
Philadelphia Chromosome ◽  
Chronic Phase ◽  
Myelogenous Leukemia ◽  
Lower Percentage ◽  
High Dose ◽  
Intensive Chemotherapy ◽  
Hematopoietic Recovery ◽  
Diploid Cells

PURPOSE To evaluate whether intensive chemotherapy followed by peripheral stem-cell (PSC) collections during early hematopoietic recovery results in a higher percentage of diploid cell collections in patients with Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML). PATIENTS AND METHODS Fifty-five adults with Ph-positive CML received intensive chemotherapy with daunorubicin and high-dose cytarabine (ara-C) (DAUNO-HDAC; 26 patients) or fludarabine, high-dose ara-C, and mitoxantrone (FAM; 29 patients). Collections of the peripheral mononuclear cells were initiated when the WBC count was > or = 0.8 x 10(3)/microL. Simultaneous peripheral and marrow samples were subjected to cytogenetic studies. RESULTS Thirty-eight of 55 patients (69%) were able to undergo the PSC collections. The rate of collection was higher in chronic phase (26 of 30 patients; 87%) than in accelerated (11 of 17; 65%) and blastic phases (1 of 8; 12%). Among the 30 patients in chronic phase, cytogenetic analyses of PSC showed cytogenetic responses (Ph-positive < 95%) in 60%, which were major (Ph < 35%) in 43% and complete (Ph = 0%) in 27%. Seven of 19 patients with simultaneous studies (37%; 23% of total) had a significantly lower percentage of Ph-positive cells in the peripheral collection compared with the marrow collection; one had the reverse phenomenon (5%; 3% of total). Cytogenetic responses were modest in both peripheral and marrow collections in CML accelerated and blastic phases. Myelosuppression-associated complications were frequent, resulting in febrile episodes in 76% of patients. CONCLUSION PSC collection during early hematopoietic recovery from intensive chemotherapy allowed the collection of diploid-rich stem cells, mostly in chronic-phase CML. The approach could be used for in vivo purging before autologous stem-cell transplantation (ASCT).

scholarly journals CML-T1: a cell line derived from T-lymphocyte acute phase of chronic myelogenous leukemia

Blood ◽  
1989 ◽  
Vol 74 (4) ◽  
pp. 1381-1387 ◽  
Author(s):  
K Kuriyama ◽  
RP Gale ◽  
M Tomonaga ◽  
S Ikeda ◽  
E Yao ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Line ◽  
Chronic Myelogenous Leukemia ◽  
Acute Phase ◽  
T Lymphocyte ◽  
Messenger Rna ◽  
Chromosome 9 ◽  
Myelogenous Leukemia ◽  
Hematopoietic Stem ◽  
Ph Chromosome

Abstract Most data suggest that malignant transformation in chronic myelogenous leukemia (CML) occurs in hematopoietic stem cell that is the progenitor of myelopoiesis and of B but not T lymphopoiesis. We established a T- lymphoid cell line (CML-T1) from a person with Ph-chromosome-negative CML in acute phase. Evidence of its T-lymphocyte origin includes the pattern cytochemical reactivity, reactivity with anti-T-cell monoclonal antibodies (MoAbs), and rearrangement of the beta-T-cell receptor (TCRB) gene. CML-T1 cells have features of type IV thymocytes. Cytogenetic analyses indicate a 47,XX, del(11), t(6;7)(q23;q24), +mar karyotype. CML-T1 cells exhibit molecular changes typical of CML, including translocation of the ABL protooncogene from chromosome 9 to 22, rearrangement of the BCR gene, and transcription of a chimeric BCR- ABL messenger RNA (mRNA). The ABL insertion on chromosome 22 appears interstitial, similar to other cases of Ph-chromosome-negative CML. These data clearly indicate that T cells can be involved in acute-phase CML. CML-T1 should be useful in studying this process as well as that underlying Ph-chromosome-negative CML.

scholarly journals p53 in chronic myelogenous leukemia in acute phase.

1991 ◽  
Vol 88 (14) ◽  
pp. 6293-6297 ◽  
Author(s):  
E. Feinstein ◽  
G. Cimino ◽  
R. P. Gale ◽  
G. Alimena ◽  
R. Berthier ◽  
...  
Keyword(s):  
Chronic Myelogenous Leukemia ◽  
Acute Phase ◽  
Myelogenous Leukemia
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