Johnson R J, Smith G M
Department of Haematology, The General Infirmary at Leeds, Yorkshire, UK.
Leuk Lymphoma. 1997 Nov;27(5-6):401-15. doi: 10.3109/10428199709058307.
Unmanipulated autologous transplantation of marrow of peripheral blood stem cells has been performed in small numbers of patients with CML for many years. More recently there has been interest in attempting to 'purge' the autograft of clonal cells as defined by the presence of the Philadelphia chromosome or BCR-ABL rearrangement. One method by which this might be achieved in vivo has been developed in Genoa and involves the administration of high dose chemotherapy and G-CSF followed by peripheral blood stem cell collection. These collections are frequently devoid of Philadelphia positive cells and the hope is that this will enhance the effects of subsequent autograft. We have investigated the use of a less toxic regimen for this procedure using oral hydroxyurea and G-CSF. In this review we describe the background to autografting in CML and the development of strategies to mobilise Philadelphia negative cells into the peripheral blood. We go on to present an update of our data using hydroxyurea and discuss some of the practical and theoretical issues behind the procedure.
多年来，少数慢性粒细胞白血病患者接受了未处理的自体骨髓或外周血干细胞移植。最近，人们对尝试“清除”自体移植物中由费城染色体或BCR-ABL重排所定义的克隆细胞产生了兴趣。在热那亚已经开发出一种可能在体内实现这一目标的方法，该方法包括给予高剂量化疗和粒细胞集落刺激因子（G-CSF），随后进行外周血干细胞采集。这些采集物通常不含费城染色体阳性细胞，人们希望这将增强后续自体移植的效果。我们研究了使用口服羟基脲和G-CSF进行该操作的毒性较小的方案。在这篇综述中，我们描述了慢性粒细胞白血病自体移植的背景以及将费城染色体阴性细胞动员到外周血中的策略的发展。我们接着介绍使用羟基脲的最新数据，并讨论该操作背后的一些实际和理论问题。
