Mini-ICE regimen as mobilization therapy for chronic myelogenous leukaemia patients at diagnosis

Bone Marrow Transplant. 1999 Dec;24(12):1285-90. doi: 10.1038/sj.bmt.1702068.

Abstract

Between April 1996 and May 1998, 20 consecutive patients with Ph chromosome-positive CML in first chronic phase without an HLA-identical sibling received the mini-ICE regimen shortly after diagnosis to mobilize progenitor cells into the peripheral blood (PBPCs). The sex distribution was 12 males and eight females and the median (range) age 48.5 (22-62) years. The time interval between diagnosis and mobilization was a median (range) of 2 (0-5) months. Leukaphereses were initiated during recovery from chemotherapy-induced aplasia. A median number of 3 (1-7) aphereses per patient were performed to collect >/=2.0 x 106 CD34+cells/kg. Cytogenetic analysis was performed on the aphereses products of 18 patients. Complete cytogenetic Ph chromosome negativity was observed in four patients, nine had a partial negativity, three a minimal negativity and two no negative cells. Southern blot for bcr-abl was negative in the remaining two patients but the polymerase chain reaction analysis was positive. Following reinfusion, severe neutropenia was present for a median of 8.5 (3-19) days and severe thrombocytopenia lasted a median of 8 (3-18) days. Ten patients did not develop febrile neutropenia with four of them being treated on an outpatient basis. Treatment-related mortality was not observed. In conclusion, our experience demonstrates the feasibility of mobilizing PBPCs shortly after the diagnosis of CML with a safe regimen. Of note, mini-ICE allowed the collection of apheresis products with at least a major component of Ph-negative cells in almost 75% of the patients.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antigens, CD34 / blood
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / toxicity
  • Blood Cell Count
  • Blood Component Removal / methods
  • Carboplatin / administration & dosage
  • Carboplatin / toxicity
  • Cytogenetic Analysis
  • Etoposide / administration & dosage
  • Etoposide / toxicity
  • Female
  • Hematopoietic Stem Cell Mobilization*
  • Humans
  • Ifosfamide / administration & dosage
  • Ifosfamide / toxicity
  • Interferon-alpha / therapeutic use
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / blood
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / diagnosis*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy*
  • Leukocyte Count
  • Leukocytes, Mononuclear
  • Male
  • Middle Aged
  • Neutrophils
  • Philadelphia Chromosome
  • Platelet Count
  • Time Factors
  • Transplantation, Autologous

Substances

  • Antigens, CD34
  • Interferon-alpha
  • Etoposide
  • Carboplatin
  • Ifosfamide

Supplementary concepts

  • ICE protocol 3