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Type: Journal article
Title: Mobilization of predominantly Philadelphia chromosome-negative blood progenitors using cyclophosphamide and rHUG-CSF in early chronic-phase chronic myeloid leukaemia: correlation with Sokal prognostic index and haematological control.
Author: Hughes, T.
Grigg, A.
Szer, J.
Ho, J.
Ma, D.
Dale, B.
Green, R.
Norman, J.
Sage, R.
Herrmann, R.
Cannell, P.
Schwarer, A.
Taylor, K.
Atkinson, K.
Arthur, C.
Citation: British Journal of Haematology, 1997; 96(3):635-640
Publisher: Blackwell Publishing
Issue Date: 1997
ISSN: 0007-1048
Abstract: Mobilization of Philadelphia chromosome (Ph) negative blood progenitors was attempted in 23 newly diagnosed chronic myeloid leukaemia (CML) patients using a regimen of cyclophosphamide (CY) 5 g/m² and rHUG-CSF 150 μg/m² daily. This regimen was well tolerated with no major adverse events reported. More than 2 × 10⁶/kg CD34⁺ cells were collected in 21 patients (91%). Predominantly Ph-negative mobilization (0–25% Ph-positive) was seen in 30% of cases overall and was confined to patients with a Sokal prognostic score < 1 (7/11 with Sokal score <1; 0/12 with Sokal score ≥1). Within the low Sokal index group, a low WBC count pre-mobilization and a low WBC nadir both correlated strongly with Ph-negative mobilization (P =0.006 and 0.02 respectively). Five of 19 patients receiving at least 6 months of Roferon A therapy post mobilization achieved a major cytogenetic response; all five patients were Ph-negative mobilizers. Therefore CML patients can be divided into a good-prognosis group in whom predominantly Ph-negative progenitors can be mobilized using a regimen of moderate intensity if haematological control is achieved pre-mobilization, and a poor-prognosis group for whom predominantly Ph-positive cells are mobilized with this regimen regardless of haematological control.
Keywords: Hematopoietic Stem Cells
Leukemia, Myeloid, Chronic-Phase
Granulocyte Colony-Stimulating Factor
Treatment Outcome
Hematopoietic Stem Cell Transplantation
Transplantation, Autologous
Middle Aged
DOI: 10.1046/j.1365-2141.1997.d01-2068.x
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