autologous blood and marrow transplantation - Blog Science ...

Carella et al.
erythropoietin followed by corticosteroids and chemotherapy without success. She
received weekly red cell transfusions to maintain hemoglobin at 7-8 g/dL. All
metaphases contained t(l,3) (p36;q21). On day 63 after allografting*, the karyotype
showed only 46 XY without evidence of the 1; 3 translocation. Reticulocytosis of
12% was documented on day 40 and was followed by an increase in hemoglobin
to 12.6 by day 63. No sign of acute GVHD was observed.
The second patient had CML diagnosed in 1996 without evidence of Ph
chromosome, but the pi90 BCR-ABL gene was detected by RT-PCR. He was
treated with hydroxyurea and interferon-alpha (5 mU/m 2
/d) for 6 months, but the
RT-PCR remained positive and the white blood cell (WBC) count and platelets
increased. In October 1997, the disease was considered to be in accelerated phase,
WBC 105X10 9
/L and platelets 1200X10 9
/L. He was treated with the mini-ICE
protocol 4
and, while recovering from aplasia, underwent leukaphereses which
yielded only PCR-positive cells with BCR-ABL/ABL ratio of 0.1. The patient
received an autotransplant but no change in BCR-ABL/ABL ratio was seen, and
the white count and platelets remained high. He had an HLA-matched brother age
69 years; after he received the Flu-Cy protocol, mobilized donor hematopoietic
stem cells were infused. Granulocytes and platelets never decreased below
1X10 9
/L and 20X10 9
/L, respectively. He was discharged on day 14 and followed
as an outpatient. Complete chimerism was achieved on day 108 (100% donor cells)
with BCR-ABL/ABL ratio 0.0008. On day 240, complete chimerism with BCR-
ABL/ABL ratio