Olavarria E, Parker S, Craddock C, Philpott N, Tiniakou M, Chase A, Kanfer E, Apperley J F, Goldman J M
Haematology Department, Hammersmith Hospital, ICSM, Du Cane Road, London W12 0NN, UK.
Haematologica. 2000 Jun;85(6):647-52.
The observation that patients with chronic myeloid leukemia (CML) may relapse following stem cell transplantation because of Philadelphia positive cells contaminating the graft have led to a variety of strategies to reduce this contamination. This study investigate the feasibility of collective, Ph-re cells from patients with CML in chronic phase.
A total of 18 patients with chronic myeloid leukemia in chronic phase who had responded to varying degrees to treatment with interferon-a (IFN) were subjected to mobilization with granulocyte colony-stimulating factors and peripheral blood progenitor cell collection. Nine patients were in complete cytogenetic remission (CCR) and nine were partial responders. IFN was stopped 2 to 4 weeks before the procedure. G-CSF was given by subcutaneous injection once daily at a dose of 10 microg/kg.
Five patients underwent one collection procedure only, 10 underwent two procedures and 3 patients had three collections. The median number of nucleated cells (NC) per patient collected was 10.2 x 10(8)/kg (4.4-19.7) and the median number of CD34(+) cells was 2.5 x 10(6)/kg (0.4-9.4). Analyzable cytogenetic data were available for 26/34 (76%) leukapheresis procedures. The median percentage of Ph- negative metaphases for patients in CCR was 100% (73-100). Patients not in CCR had a higher level of Ph-positive cells in their collections (median 23%, range 0-79%, p=0.01). Of the nine patients in CCR, 8 had at least one apheresis from which progenitor cells were 100% Ph-negative; conversely, patients not in CCR had detectable Ph-positive cells in every collection. Four patients have undergone autologous stem cell transplantation.
It was possible to collect sufficient Ph negative progenitor cells from patients in CCR but collections from other patients contained significant numbers of Ph-positive cells.
慢性髓性白血病（CML）患者在干细胞移植后可能因移植中污染费城染色体阳性细胞而复发，这一观察结果促使人们采取了多种策略来减少这种污染。本研究探讨从慢性期CML患者中收集费城染色体阴性（Ph-）细胞的可行性。
总共18例慢性期慢性髓性白血病患者，这些患者对干扰素-α（IFN）治疗有不同程度的反应，接受了粒细胞集落刺激因子动员及外周血祖细胞采集。9例患者处于完全细胞遗传学缓解（CCR）状态，9例为部分缓解者。在操作前2至4周停用IFN。皮下注射G-CSF，每日1次，剂量为10μg/kg。
5例患者仅进行了1次采集程序，10例进行了2次程序，3例患者进行了3次采集。每位患者采集的有核细胞（NC）中位数为10.2×10⁸/kg（4.4 - 19.7），CD34⁺细胞中位数为2.5×10⁶/kg（0.4 - 9.4）。26/34（76%）次白细胞分离程序可获得可分析的细胞遗传学数据。处于CCR的患者Ph阴性中期分裂相的中位数百分比为100%（73 - 100）。未处于CCR的患者采集物中费城染色体阳性细胞水平较高（中位数23%，范围0 - 79%，p = 0.01）。在9例处于CCR的患者中，8例至少有1次采集的祖细胞为100% Ph阴性；相反，未处于CCR的患者每次采集物中均有可检测到的Ph阳性细胞。4例患者已接受自体干细胞移植。
从处于CCR的患者中有可能收集到足够的Ph阴性祖细胞，但其他患者的采集物中含有大量Ph阳性细胞。
