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Intensive chemotherapy in patients with chronic myelogenous leukaemia (CML) in accelerated or blastic phase - A report from the Swedish CML Group
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2002 (English)In: British Journal of Haematology, ISSN 0007-1048, Vol. 118, no 4, 1048-1054 p.Article in journal (Refereed) Published
Abstract [en]

In attempting to restore the chronic phase (CP) of chronic myelogenous leukaemia (CML), the Swedish CML group utilized an intensive chemotherapy protocol for 83 patients (aged 16-79 years) in accelerated (AP, n = 22) or blastic phase (BC, n = 61). Most patients received a combination of mitoxantrone (12 mg/m2/d) and etoposide (100 mg/m2/d) together with cytosine arabinoside (1 g/m2 b.i.d) for 4 d. Overall, 39 patients (47%) achieved a second CP (CP2)/partial remission (PR). Responding patients <65 years were eligible for ablative chemotherapy followed by an allogeneic (SCT) or a double autologous stem cell transplant (ASCT). Seventeen of 34 responders <65 years failed to proceed to transplantation as a result of early disease progression (n = 15) or disease-related complications (n = 2). The remaining 17 patients underwent SCT (n = 9, including four unrelated donor SCT) or ASCT (n = 8). Only one of the eight ASCT patients had a second ASCT, the remaining seven failed because of progression (n = 5) or hypoplasia (n = 2). The median duration of CP2/PR was 6 months (range 1-72 months). Five patients achieved a longer CP2/PR than CP1. The 1 year survival was 70% for SCT/ASCT patients (median survival 21 months), 50% for responding patients overall, but only 7% for non-responders (P < 0.001). Three SCT/ASCT patients are long-term survivors (65+, 66+ and 73+ months). In conclusion, approximately half of the patients achieved a CP2/PR after intensive chemotherapy, with a clear survival advantage for responders vs non-responders. Subsequent SCT/ASCT was feasible for half of the responders (<65 years), and one individual underwent double ASCT. Novel therapeutic options for CML patients in AP/BP are needed.

Place, publisher, year, edition, pages
2002. Vol. 118, no 4, 1048-1054 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-25269DOI: 10.1046/j.1365-2141.2002.03765.xLocal ID: 9709OAI: diva2:245597
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-13

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Malm, Claes
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Faculty of Health SciencesHematologyDepartment of Haematology UHL
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