Lack of efficacy of a double autograft program to prolong survival of chronic myelogenous leukemia patients in blastic transformation

Abstract

The prognosis of patients in blast crisis of chronic myelogenous leukemia treated with conventional polychemotherapy is extremely poor. Autologous blood stem cell transplantation has been proposed by several authors, and the possibility of achieving a second chronic phase (CP), albeit very short lived, has been reported. In our study, we evaluated the feasibility and efficacy of a double sequential autograft program utilizing two different conditioning regimens. Nine patients underwent the first autograft, but only three were eligible for the second because of one early death, four relapses and one patient who underwent mismatched alloBMT. Of the three patients receiving the second graft, we observed 2 toxic deaths and one relapse six months after transplantation. We conclude that our experience with double autograft in this phase of the disease is very disappointing. since it was associated with prohibitive toxicity in the absence of any advantages in terms of survival for these patients.