Intensive chemotherapy in patients with chronic myelogenous leukaemia (CML) in accelerated or blastic phase - a report from the Swedish CML Group
(2002) In British Journal of Haematology 118(4). p.1048-1054- Abstract
- In attempting to restore the chronic phase (CP) of chronic myelogenous leukaemia (CML), the Swedish CML group utilized an intensive chemotherapy protocol for 83 patients (aged 16-79 years) in accelerated (AP, n = 22) or blastic phase (BC, n = 61). Most patients received a combination of mitoxantrone (12 mg/m(2) /d) and etoposide (100 mg/m(2) /d) together with cytosine arabinoside (1 g/m(2) b.i.d) for 4 d. Overall, 39 patients (47%) achieved a second CP (CP2)/partial remission (PR). Responding patients < 65 years were eligible for ablative chemotherapy followed by an allogeneic (SCT) or a double autologous stem cell transplant (ASCT). Seventeen of 34 responders < 65 years failed to proceed to transplantation as a result of early... (More)
- In attempting to restore the chronic phase (CP) of chronic myelogenous leukaemia (CML), the Swedish CML group utilized an intensive chemotherapy protocol for 83 patients (aged 16-79 years) in accelerated (AP, n = 22) or blastic phase (BC, n = 61). Most patients received a combination of mitoxantrone (12 mg/m(2) /d) and etoposide (100 mg/m(2) /d) together with cytosine arabinoside (1 g/m(2) b.i.d) for 4 d. Overall, 39 patients (47%) achieved a second CP (CP2)/partial remission (PR). Responding patients < 65 years were eligible for ablative chemotherapy followed by an allogeneic (SCT) or a double autologous stem cell transplant (ASCT). Seventeen of 34 responders < 65 years failed to proceed to transplantation as a result of early disease progression (n = 15) or disease-related complications (n = 2). The remaining 17 patients underwent SCT (n = 9; including four unrelated donor SCT) or ASCT (n = 8). Only one of the eight ASCT patients had a second ASCT; the remaining seven failed because of progression (n = 5) or hypoplasia (n = 2). The median duration of CP2/PR was 6 months (range 1-72 months). Five patients achieved a longer CP2/PR than CP1. The 1 year survival was 70% for SCT/ASCT patients (median survival 21 months), 50% for responding patients overall, but only 7% for non-responders (P < 0.001). Three SCT/ASCT patients are long-term survivors (65+, 66+ and 73+ months). In conclusion, approximately half of the patients achieved a CP2/PR after intensive chemotherapy, with a clear survival advantage for responders vs non-responders. Subsequent SCT/ASCT was feasible for half of the responders (< 65 years), and one individual underwent double ASCT. Novel therapeutic options for CML patients in AP/BP are needed. (Less)
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https://lup.lub.lu.se/record/892727
- author
- organization
- publishing date
- 2002
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- accelerated/blastic phase, CML, stem cell transplantation
- in
- British Journal of Haematology
- volume
- 118
- issue
- 4
- pages
- 1048 - 1054
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000177746900017
- pmid:12199784
- scopus:18544380649
- ISSN
- 0007-1048
- DOI
- 10.1046/j.1365-2141.2002.03765.x
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)
- id
- f69873a9-5c97-49bc-a66f-f3ce11229e24 (old id 892727)
- date added to LUP
- 2016-04-01 12:06:15
- date last changed
- 2022-06-16 08:09:32
@article{f69873a9-5c97-49bc-a66f-f3ce11229e24, abstract = {{In attempting to restore the chronic phase (CP) of chronic myelogenous leukaemia (CML), the Swedish CML group utilized an intensive chemotherapy protocol for 83 patients (aged 16-79 years) in accelerated (AP, n = 22) or blastic phase (BC, n = 61). Most patients received a combination of mitoxantrone (12 mg/m(2) /d) and etoposide (100 mg/m(2) /d) together with cytosine arabinoside (1 g/m(2) b.i.d) for 4 d. Overall, 39 patients (47%) achieved a second CP (CP2)/partial remission (PR). Responding patients < 65 years were eligible for ablative chemotherapy followed by an allogeneic (SCT) or a double autologous stem cell transplant (ASCT). Seventeen of 34 responders < 65 years failed to proceed to transplantation as a result of early disease progression (n = 15) or disease-related complications (n = 2). The remaining 17 patients underwent SCT (n = 9; including four unrelated donor SCT) or ASCT (n = 8). Only one of the eight ASCT patients had a second ASCT; the remaining seven failed because of progression (n = 5) or hypoplasia (n = 2). The median duration of CP2/PR was 6 months (range 1-72 months). Five patients achieved a longer CP2/PR than CP1. The 1 year survival was 70% for SCT/ASCT patients (median survival 21 months), 50% for responding patients overall, but only 7% for non-responders (P < 0.001). Three SCT/ASCT patients are long-term survivors (65+, 66+ and 73+ months). In conclusion, approximately half of the patients achieved a CP2/PR after intensive chemotherapy, with a clear survival advantage for responders vs non-responders. Subsequent SCT/ASCT was feasible for half of the responders (< 65 years), and one individual underwent double ASCT. Novel therapeutic options for CML patients in AP/BP are needed.}}, author = {{Turesson, Ingemar and Axdorph, U and Vilen, L and Stenke, L and Uden, AM and Grimfors, G and Bjorkholm, M and Carneskog, J and Hansen, J and Linder, O and Ljungman, P and Lofvenberg, E and Malm, C and Simonsson, B and Vilen, L and Uden, AM and Bjorkholm, M}}, issn = {{0007-1048}}, keywords = {{accelerated/blastic phase; CML; stem cell transplantation}}, language = {{eng}}, number = {{4}}, pages = {{1048--1054}}, publisher = {{Wiley-Blackwell}}, series = {{British Journal of Haematology}}, title = {{Intensive chemotherapy in patients with chronic myelogenous leukaemia (CML) in accelerated or blastic phase - a report from the Swedish CML Group}}, url = {{http://dx.doi.org/10.1046/j.1365-2141.2002.03765.x}}, doi = {{10.1046/j.1365-2141.2002.03765.x}}, volume = {{118}}, year = {{2002}}, }