AUTOGRAFTING FOR PATIENTS WITH CML IN CHRONIC PHASE - AN UPDATE

Between 1984 and 1992, 21 patients with chronic myeloid leukaemia (CML ) in chronic phase (CP) were treated with high-dose chemotherapy (or c hemoradiotherapy) followed by autografting with unmanipulated peripher al blood stem cells (PBSC). 12 of these patients survive at a median o f 82 months from the time of autografting (range 9-105 months). Nine p atients died, six of leukaemia in transformation and three from other causes. Survival of these 21 autograft patients was compared to that o f 636 age-matched controls on the Medical Research Council's (MRC) dat a base, who had been treated with conventional chemotherapy over the s ame period. Autografted patients had a significantly longer survival a t 5 years post autograft than chemotherapy patients (56% v 28%) even a fter appropriate allowance for time at risk before autograft (Mantel-B yar, 2P=0.003). There was no difference in survival whether autografti ng was performed early in the disease or later or whether the PBSC had been harvested soon after diagnosis or later. If the benefits of auto grafting in chronic phase seen in this non-randomized series can be co nfirmed in a randomized study, autografting might be the treatment of choice for younger CML patients who do not have suitable donors for al logeneic transplant.