C. Boque et al., MOBILIZATION OF PERIPHERAL STEM-CELLS WITH INTENSIVE CHEMOTHERAPY (ICE REGIMEN) AND G-CSF IN CHRONIC MYELOID-LEUKEMIA, Bone marrow transplantation, 18(5), 1996, pp. 879-884
Seventeen patients with Philadelphia (Ph) chromosome-positive chronic
myeloid leukemia (CML) were treated with the ICE regimen plus G-CSF wi
th the aim of mobilizing and collecting Ph-negative peripheral stem ce
lls (PSC) in the setting of an autotransplant program, Fifteen patient
s had CR IL in first chronic phase (CP), and two in accelerated phase
(AP), Three patients had been previously treated with interferon alpha
2a (IFN), Twelve patients underwent leukaphereses and a mean of 4.7 x
10(8)/kg mononuclear cells were obtained, Four CP patients did not sh
ow a significant mobilization peak of CD34(+) cells and leukapheresis
was not performed; finally, one patient died before apheresis could be
performed, Six of the 12 who underwent leukaphereses obtained more th
an 1.0 x 10(6)/kg CD34(+) cells, Eight of the 12 mobilized patients (6
7%) obtained a major cytogenetic response, including two complete and
sis partial; in the remaining four patients minimal or absent cytogene
tic responses were observed, A higher rate of Ph purging was obtained
in patients mobilized early or showing residual Ph-negative cells befo
re mobilization, even if they mere in AP. Infectious complications wer
e frequent with a 38% rate of bacteremia recorded and one case of pulm
onary aspergillosis resulting in a toxicity similar to that occurring
in acute myeloid leukemia-induction chemotherapy. The ICE regimen can
promote 'in vivo' purging of the Ph+ cells in 67% of CML mobilized pat
ients (8/12), Failure of mobilization occurs in 65% of patients (11/17
), mainly because of poor CD34(+) cell yield.