Mini-ICE regimen as mobilization therapy for chronic myelogenous leukaemiapatients at diagnosis

Between April 1996 and May 1998, 20 consecutive patients with Ph chromosome -positive CML in first chronic phase without an HLA-identical sibling recei ved the mini-ICE regimen shortly after diagnosis to mobilize progenitor cel ls into the peripheral blood (PBPCs), The sex distribution was 12 males and eight females and the median (range) age 48.5 (2262) years. The time inter val between diagnosis and mobilization was a median (range) of 2 (0-5) mont hs. Leukaphereses were initiated during recovery from chemotherapy-induced aplasia, A median number of 3 (1-7) aphereses per patient were performed to collect greater than or equal to 2.0 x 10(6) CD34(+) cells/kg, Cytogenetic analysis was performed on the aphereses products of 18 patients. Complete cytogenetic Ph chromosome negativity was observed in four patients, nine ha d a partial negativity, three a minimal negativity and two no negative cell s. Southern blot for bcr-abl was negative in the remaining two patients but the polymerase chain reaction analysis was positive. Following reinfusion, severe neutropenia was present for a median of 8.5 (3-19) days and severe thrombocytopenia lasted a median of 8 (3-18) days. Ten patients did not dev elop febrile neutropenia with four of them being treated on an outpatient b asis. Treatment-related mortality was not observed. In conclusion, our expe rience demonstrates the feasibility of mobilizing PBPCs shortly after the d iagnosis of CML with a safe regimen. Of note, mini-ICE allowed the collecti on of apheresis products with at least a major component of Ph-negative cel ls in almost 75% of the patients.