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Table of Contents
Vol. 113, No. 3, 2005
Issue release date: April 2005
Section title: Original Paper
Acta Haematol 2005;113:155–162
(DOI:10.1159/000084445)

Intensive Treatment and Stem Cell Transplantation in Chronic Myelogenous Leukemia: Long-Term Follow-Up

Simonsson B.a · Öberg G.a · Björeman M.b · Björkholm M.c · Carneskog J.d · Karlsson K.h · Gahrton G.e · Grimfors G.c · Hast R.c · Karle H.m · Linder O.b · Ljungman P.e · Nielsen J.L.k · Nilsson J.f · Löfvenberg E.g · Malm C.h · Olsson K.a · Olsson-Strömberg U.a · Paul C.e · Stenke L.c · Stentoft J.k · Turesson I.i · Udén A.-M.e · Wahlin A.g · Vilén L.j · Weis-Bjerrum O.l
Departments of Medicine and Hematology,aUniversity Hospital, Uppsala, bUniversity Hospital, Örebro, cKarolinska Hospital, Stockholm, dSahlgrenska Hospital, Gothenburg, eHuddinge University Hospital, Huddinge, fRegional Oncologic Center in Uppsala/Örebro, Uppsala, gUniversity Hospital, Umeå, hUniversity Hospital, Linköping, iMalmö University Hospital, Malmö, and jEast Hospital, Gothenburg, Sweden; Departments of Medicine and Hematology, kAmtssygehuset, Århus, and lRigshospitalet and mHerlev Hospital, Copenhagen, Denmark

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 18, 2003
Accepted: July 07, 2004
Published online: May 02, 2005
Issue release date: April 2005

Number of Print Pages: 8
Number of Figures: 6
Number of Tables: 3

ISSN: 0001-5792 (Print)
eISSN: 1421-9662 (Online)

For additional information: http://www.karger.com/AHA

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.

© 2005 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 18, 2003
Accepted: July 07, 2004
Published online: May 02, 2005
Issue release date: April 2005

Number of Print Pages: 8
Number of Figures: 6
Number of Tables: 3

ISSN: 0001-5792 (Print)
eISSN: 1421-9662 (Online)

For additional information: http://www.karger.com/AHA


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.