Treatment of chronic myeloid leukemia with autologous transplantation using peripheral blood stem cells or bone marrow cultured in IL-2 followed by IL-2, GM-CSF,and IFN-alpha administration |
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Authors: | Hájek Roman Zácková Daniela Büchler Tomás Penka Miroslav Krahulcová Eva Korístek Zden?k Vinklárková Jaroslava Adler Jiri Janovská Eva Indrák Karel Faber Edgar Doubek Michal Klabusay Martin Oltová Alexandra Kuglík Petr Bourková Ludmila Dusek Ladislav Mareschová Iveta Mayer Jiri Vorlícek Jiri |
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Institution: | (1) Department of Internal Medicine — Hematooncology, University Hospital Brno Bohunice, Jihlavská 20, 639 00 Brno, Czech Republic;(2) Department of Clinical Hematology, University Hospital Brno, Czech Republic;(3) Department of Medical Genetics, University Hospital Brno, Czech Republic;(4) Department of Hematology and Oncology, University Hospital, Olomouc, Czech Republic;(5) Department of Genetics and Molecular Biology, Faculty of Natural Sciences, Czech Republic;(6) Centre of Biostatistics and Analyses, Masaryk University Brno, Czech Republic |
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Abstract: | Interleukin-2 (IL-2) is able to generate nonspecific cytotoxic effectors from hematopoietic precursors. We evaluated the feasibility
and efficacy of chronic myeloid leukemia (CML) treatment with autologous hematopoietic stem cell transplantation (HSCT) using
grafts cultured in IL-2 followed by immunotherapy with IL-2, granulocyte-macrophage colony-stimulating factor (GM-CSF), and
interferon (IFN)-α. Eight patients with CML were enrolled: five in an accelerated phase and three in a chronic phase. They
received peripheral blood stem cells (PBSC) or bone marrow (BM) cultured in a medium containing IL-2 for 24 h. A median of
1.29 × 106 CD34+ cells/kg were infused after conditioning with busulfan (12–16 mg/kg) in PBSC recipients. BM was infused without prior
myeloablative therapy. The engraftment occurred with a median of 15 d. Engraftment failure developed in one patient. The transplantation
was followed by a 1-mo regimen of IL-2 (0.5 × 106 IU/m2 daily) and GM-CSF, and 6 mo of IFN-α. One complete and one transient minor cytogenetic remission were observed. At 24 mo
after transplantation, two patients had died of progressive disease and one of infection. Five patients had stable disease
in the chronic phase. Autologous transplantation using IL-2-activated graft is feasible and the subsequent IL-2, GM-CSF, and
IFN-α administration has acceptable toxicity. However, no benefits in comparison with conventional autologous transplantation
for CML were identified in our study.
Tissue Bank, University Hospital Brno, Czech Republic |
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Keywords: | Chronic myeloid leukemia interleukin-2 immunotherapy hematopoietic stem cell transplantation |
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