Intensive chemotherapy, total body irradiation, and autologous marrow transplantation for chronic granulocytic leukemia-blast phase: report of four additional cases.

1984 ◽  
Vol 2 (5) ◽  
pp. 379-384 ◽  
Author(s):  
G L Phillips ◽  
G P Herzig
Keyword(s):  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Philadelphia Chromosome ◽  
Stable Phase ◽  
Intensive Chemotherapy ◽  
Blast Phase ◽  
Interesting Phenomenon ◽  
Chronic Granulocytic Leukemia ◽  
Total Body ◽  
Granulocytic Leukemia

Four patients with Philadelphia chromosome (Ph1)-positive chronic granulocytic leukemia (CGL) in blast phase received cyclophosphamide, total body irradiation, and autologous marrow transplants using cryopreserved marrow from the stable phase. Two patients fully reestablished stable-phase leukemia that lasted for 26 and six months; the first patient developed transient Ph1-negative hematopoiesis after transplantation. Three patients eventually died of recurrent blast-phase leukemia. Previous studies using autologous marrow for CGL have reported an occasional long survivor, but incomplete engraftment and especially the rapid recurrence of blast-phase leukemia have been responsible for the overall poor results. The latter problem complicates even normal marrow transplantation, indicating the inadequacy of the current therapeutic regimens used for treating blast-phase leukemia and the possibility of improving results with more effective regimens and autologous marrow transplantation. Although it is unknown whether the reestablishment of Ph1-negative hematopoiesis after transplantation contributes to improved survival, this interesting phenomenon must be investigated further.

Successful Treatment of Juvenile Chronic Granulocytic Leukemia With Marrow Transplantation

PEDIATRICS ◽  
1979 ◽  
Vol 63 (1) ◽  
pp. 44-46
Author(s):  
Jean E. Sanders ◽  
C. Dean Buckner ◽  
Patricia Stewart ◽  
E. Donnall Thomas
Keyword(s):  
Bone Marrow ◽  
Maintenance Therapy ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Marrow Transplant ◽  
Successful Outcome ◽  
Chronic Granulocytic Leukemia ◽  
Total Body ◽  
Granulocytic Leukemia ◽  
Disease Free

A 46-month-old boy with juvenile chronic granulocytic leukemia was treated intensively with hydroxyurea dimethyl myleran, cyclophosphamide, and total body irradiation. He then received a marrow transplant from an HL-A matched brother. Thirty-two months after the transplantation, he is hematologically normal and remains disease free on no-maintenance therapy. The successful outcome of this case suggests that a bone marrow transplant for any patient with a suitable histocompatible donor should be considered in the treatment of this disease.

scholarly journals Prognostic discrimination among younger patients with chronic granulocytic leukemia: relevance to bone marrow transplantation

Blood ◽  
1985 ◽  
Vol 66 (6) ◽  
pp. 1352-1357 ◽  
Author(s):  
JE Sokal ◽  
M Baccarani ◽  
S Tura ◽  
M Fiacchini ◽  
F Cervantes ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Cox Model ◽  
Prognostic Significance ◽  
Philadelphia Chromosome ◽  
Prognostic Indicators ◽  
Average Risk ◽  
Chronic Granulocytic Leukemia ◽  
Granulocytic Leukemia

Abstract To obtain information relevant to the question of bone marrow transplantation, we examined the prognostic significance of disease features recorded at the time of diagnosis among 625 patients, aged 5 to 45, with Philadelphia chromosome-positive, nonblastic chronic granulocytic leukemia. The actuarial death rate for this population was 5% during the first year after diagnosis, 12% during the second year, and averaged 22.5% per year during the next eight years. Multivariable regression analysis of features recorded in nearly all cases indicated that sex, spleen size, hematocrit, platelet count, and percentage of circulating blasts were significant prognostic indicators. Analyses of additional data available in 113 to 421 cases suggested that serum lactic dehydrogenase activity, percentage of blasts in marrow, nucleated RBCs in blood, and percentage of basophils plus eosinophils might also provide useful prognostic information. A Cox model, generated with five variables representing features recorded regularly (the first five listed), permitted segregation of these patients into three groups with significantly different survival patterns. The high- risk group exhibited an actuarial mortality of 30% during the first two years after diagnosis and an annual risk of 30% thereafter. In contrast, the most favorable group had a two-year actuarial mortality of 9% and an average risk thereafter of 17% per year, with a median survival of 5 1/2 years. We conclude that it should be possible to classify potential candidates for bone marrow transplantation according to risk with conventional therapy. Such information may be useful in making decisions regarding early v deferred marrow transplantation.

scholarly journals Prognostic discrimination among younger patients with chronic granulocytic leukemia: relevance to bone marrow transplantation

Blood ◽  
1985 ◽  
Vol 66 (6) ◽  
pp. 1352-1357 ◽  
Author(s):  
JE Sokal ◽  
M Baccarani ◽  
S Tura ◽  
M Fiacchini ◽  
F Cervantes ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Cox Model ◽  
Prognostic Significance ◽  
Philadelphia Chromosome ◽  
Prognostic Indicators ◽  
Average Risk ◽  
Chronic Granulocytic Leukemia ◽  
Granulocytic Leukemia

To obtain information relevant to the question of bone marrow transplantation, we examined the prognostic significance of disease features recorded at the time of diagnosis among 625 patients, aged 5 to 45, with Philadelphia chromosome-positive, nonblastic chronic granulocytic leukemia. The actuarial death rate for this population was 5% during the first year after diagnosis, 12% during the second year, and averaged 22.5% per year during the next eight years. Multivariable regression analysis of features recorded in nearly all cases indicated that sex, spleen size, hematocrit, platelet count, and percentage of circulating blasts were significant prognostic indicators. Analyses of additional data available in 113 to 421 cases suggested that serum lactic dehydrogenase activity, percentage of blasts in marrow, nucleated RBCs in blood, and percentage of basophils plus eosinophils might also provide useful prognostic information. A Cox model, generated with five variables representing features recorded regularly (the first five listed), permitted segregation of these patients into three groups with significantly different survival patterns. The high- risk group exhibited an actuarial mortality of 30% during the first two years after diagnosis and an annual risk of 30% thereafter. In contrast, the most favorable group had a two-year actuarial mortality of 9% and an average risk thereafter of 17% per year, with a median survival of 5 1/2 years. We conclude that it should be possible to classify potential candidates for bone marrow transplantation according to risk with conventional therapy. Such information may be useful in making decisions regarding early v deferred marrow transplantation.

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