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Intensive treatment and stem cell transplantation in chronic myelogenous leukemia: Long-term follow-up

Simonsson, B; Oberg, G; Bjoreman, M; Bjorkholm, M; Carneskog, J; Karlsson, K; Gahrton, G; Grimfors, G; Hast, R and Karle, H, et al. (2005) In Acta Haematologica 113(3). p.155-162
Abstract
In the present study we combined interferon (IFN) and hydroxyurea (HU) treatment, intensive chemotherapy and autologous stem cell transplantation (SCT) in newly diagnosed chronic myelogenous leukemia patients aged below 56 years, not eligible for allogeneic SCT. Patients who had an HLA-identical sibling donor and no contraindication went for an allogeneic SCT (related donor, RD). After diagnosis, patients not allotransplanted received HU and IFN to keep WBC and platelet counts low. After 6 months patients with Ph-positive cells still present in the bone marrow received 1-3 courses of intensive chemotherapy. Those who became Ph-negative after IFN+HU or after 1-3 chemotherapy courses underwent autologous SCT. Some patients with poor... (More)
In the present study we combined interferon (IFN) and hydroxyurea (HU) treatment, intensive chemotherapy and autologous stem cell transplantation (SCT) in newly diagnosed chronic myelogenous leukemia patients aged below 56 years, not eligible for allogeneic SCT. Patients who had an HLA-identical sibling donor and no contraindication went for an allogeneic SCT (related donor, RD). After diagnosis, patients not allotransplanted received HU and IFN to keep WBC and platelet counts low. After 6 months patients with Ph-positive cells still present in the bone marrow received 1-3 courses of intensive chemotherapy. Those who became Ph-negative after IFN+HU or after 1-3 chemotherapy courses underwent autologous SCT. Some patients with poor cytogenetic response were allotransplanted with an unrelated donor (URD). IFN+HU reduced the percentage of Ph-positive metaphases in 56% of patients, and 1 patient became Ph-negative. After one or two intensive cytotherapies 86 and 88% had a Ph reduction, and 34 and 40% became Ph-negative, respectively. In patients receiving a third intensive chemotherapy 92% achieved a Ph reduction and 8% became Ph-negative. The median survival after auto-SCT (n=46) was 7.5 years. The chance of remaining Ph-negative for up to 10 years after autologous SCT was around 20%. The overall survival for allo-SCT RD (n=91) and URD (n=28) was almost the same, i.e.≈ 60% at 10 years. The median survival for all 251 patients registered was 8 years (historical controls 3.5 years). The role of the treatment schedule presented in the imatinib era is discussed. Copyright (C) 2005 S. Karger AG, Basel. (Less)
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keywords
chronic myelogenous leukemia, chemotherapy, intensive, interferon, stem, cell transplantation, autologous and allogeneic
in
Acta Haematologica
volume
113
issue
3
pages
155 - 162
publisher
Karger
external identifiers
  • pmid:15870485
  • wos:000228848900001
  • scopus:20844454084
ISSN
1421-9662
DOI
10.1159/000084445
language
English
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yes
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801ae827-4c64-4154-8fc7-42929426f3d8 (old id 896736)
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2008-01-21 14:04:40
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@article{801ae827-4c64-4154-8fc7-42929426f3d8,
  abstract     = {In the present study we combined interferon (IFN) and hydroxyurea (HU) treatment, intensive chemotherapy and autologous stem cell transplantation (SCT) in newly diagnosed chronic myelogenous leukemia patients aged below 56 years, not eligible for allogeneic SCT. Patients who had an HLA-identical sibling donor and no contraindication went for an allogeneic SCT (related donor, RD). After diagnosis, patients not allotransplanted received HU and IFN to keep WBC and platelet counts low. After 6 months patients with Ph-positive cells still present in the bone marrow received 1-3 courses of intensive chemotherapy. Those who became Ph-negative after IFN+HU or after 1-3 chemotherapy courses underwent autologous SCT. Some patients with poor cytogenetic response were allotransplanted with an unrelated donor (URD). IFN+HU reduced the percentage of Ph-positive metaphases in 56% of patients, and 1 patient became Ph-negative. After one or two intensive cytotherapies 86 and 88% had a Ph reduction, and 34 and 40% became Ph-negative, respectively. In patients receiving a third intensive chemotherapy 92% achieved a Ph reduction and 8% became Ph-negative. The median survival after auto-SCT (n=46) was 7.5 years. The chance of remaining Ph-negative for up to 10 years after autologous SCT was around 20%. The overall survival for allo-SCT RD (n=91) and URD (n=28) was almost the same, i.e.≈ 60% at 10 years. The median survival for all 251 patients registered was 8 years (historical controls 3.5 years). The role of the treatment schedule presented in the imatinib era is discussed. Copyright (C) 2005 S. Karger AG, Basel.},
  author       = {Simonsson, B and Oberg, G and Bjoreman, M and Bjorkholm, M and Carneskog, J and Karlsson, K and Gahrton, G and Grimfors, G and Hast, R and Karle, H and Linder, O and Ljungman, P and Nielsen, JL and Nilsson, J and Lofvenberg, E and Malm, C and Olsson, K and Olsson-Stromberg, U and Paul, C and Stenke, L and Stentoft, J and Turesson, Ingemar and Uden, AM and Wahlin, A and Vilen, L and Weis-Bjerrum, O},
  issn         = {1421-9662},
  keyword      = {chronic myelogenous leukemia,chemotherapy,intensive,interferon,stem,cell transplantation,autologous and allogeneic},
  language     = {eng},
  number       = {3},
  pages        = {155--162},
  publisher    = {Karger},
  series       = {Acta Haematologica},
  title        = {Intensive treatment and stem cell transplantation in chronic myelogenous leukemia: Long-term follow-up},
  url          = {http://dx.doi.org/10.1159/000084445},
  volume       = {113},
  year         = {2005},
}