NEWER APPROACHES IN TREATING CHRONIC MYELOGENOUS LEUKEMIA

Allogeneic bone marrow transplantation (BMT) is a useful approach for treating patients with chronic myelogenous leukemia (CML). In patients who lack a suitable donor, various approaches to utilize the patient' s own hematopoietic stem cells obtained from bone marrow and/or periph eral blood have been developed. Preferential recovery of normal human hematopoietic progenitors over CML clone in long-term bone marrow cult ure (LTBMC) has been observed for a long time. LTBMC initiated in tiss ue culture (TC) flasks to that in ''Lifecell'' bags, which are gas-per meable plastic bags in which feeder-layer cells cannot adhere, has bee n investigated for several years. In our laboratory, cells were incuba ted in the presence of various growth factors to develop improved meth ods for stem cell expansion. Sustained hematopoietic stem cell growth in the absence of a feeder layer in plastic gas-permeable bags has bee n observed. Growth of marrow from patients with CML is being investiga ted extensively. Combining effective drugs to decrease the Philadelphi a (Ph) clone prior to bone marrow harvest and the use of cultured bone marrow may provide a useful method for treating patients with CML. Re sults of various international studies are also discussed below.