RESUMO
Chromosome evolution is one of the major mechanisms of disease progression and resistance in chronic myeloid leukemia (CML) patients. However, the clinical significance of chromosomal evolution in the Philadelphia (Ph)-negative clone during therapy is not fully understood. We evaluated 94 CML patients in the chronic phase of CML during treatment of the disease. Six of them had Ph-negative chromosome abnormalities during treatment. Four patients with a single abnormality and a good molecular response showed no obvious complications from the chromosomal changes, while two other patients who had complex abnormalities and previous treatment had poor outcomes. Our results highlight the need for close monitoring of this kind of patient, not only on a molecular level but also at the cytogenetic level.
Assuntos
Células da Medula Óssea/citologia , Aberrações Cromossômicas , Leucemia Mieloide Crônica Atípica BCR-ABL Negativa/terapia , Transplante de Células-Tronco , Adulto , Idoso , Medula Óssea , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto JovemRESUMO
BACKGROUND: The objective of this analysis was to evaluate the role of autologous stem cell transplantation (ASCT) in prolonging disease free survival (DFS) and overall survival (OS) in patients with chronic myeloid leukemia (CML) who received autografts of Philadelphia chromosome (Ph) positive or Ph negative cell harvests. METHODS: Over a 4-year period (1994-1999), 53 patients who underwent ASCT for CML were reported to the Argentine Group of Bone Marrow Transplantation (GATMO) Registry. RESULTS: Ph negative cell products were harvested in only 18 patients (34%). Comparison of disease status at the time of autograft, duration of neutropenia, thrombocytopenia, days of antibiotics, and transfusional requirements of red blood cells and platelets did not reveal statistical significant differences between the Ph positive group and the Ph negative group. Only days of hospitalization were increased significantly in patients who received Ph positive autografts. Although DFS at 36 months was significantly longer after infusion of Ph negative cell products (54% vs. 14%; P Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia
, Leucemia Mieloide Crônica Atípica BCR-ABL Negativa/terapia
, Transplante de Células-Tronco de Sangue Periférico
, Adolescente
, Adulto
, Intervalo Livre de Doença
, Feminino
, Hospitalização
, Humanos
, Tempo de Internação
, Leucemia Mielogênica Crônica BCR-ABL Positiva/patologia
, Masculino
, Pessoa de Meia-Idade
, Estudos Retrospectivos
, Transplante Autólogo
, Resultado do Tratamento