ABSTRACT
BACKGROUND: The therapeutic response of chronic myelogenous leukemia in myeloid blast crisis (CML-MBC) is very poor. AIM: To explore the therapeutic effect of homoharringtonine (HHT) combined with cytarabine (HA regimen) on CML-MBC and its influence on bone marrow CD34+CD7+ cells. RESULTS: Thirty-four patients with CML-MBC were treated with the HA regimen and bone marrow CD34+CD7+ cells were assayed prior to and after treatment. Among 33 evaluable patients, the overall hematological response (complete/ partial hematological response and hematological improvement) was 60.1%. Seven patients (21.2%) had a cytogenetic response 12 months after treatment. In the untreated CMLMBC patients, the proportion of bone marrow CD34+CD7+ cells was much higher than in the control group (19.4 ± 7.9 vs. 4.4 ± 1.5%, p < 0.05) and decreased to 14.1 ± 7.1% (p < 0.05) after treatment. Before treatment, the proportion of CD34+CD7+ cells was lower in the patients who had a hematological response to the HA regimen than in the patients who did not respond. CONCLUSION: The HA regimen is an effective treatment for CML-MBC and CD34+CD7+ cells may be one of the valuable clinical parameters to assess treatment effectiveness.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Blast Crisis/drug therapy , Bone Marrow/pathology , Leukemia, Myeloid, Accelerated Phase/drug therapy , Myeloid Cells/drug effects , Neoplastic Stem Cells/drug effects , Adolescent , Adult , Antigens, CD34/analysis , Antigens, CD7/analysis , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/pharmacology , Blast Crisis/pathology , Bone Marrow/drug effects , Cell Count , Consolidation Chemotherapy , Cytarabine/administration & dosage , Cytarabine/adverse effects , Cytarabine/pharmacology , Daunorubicin/administration & dosage , Drug Resistance, Neoplasm , Female , Follow-Up Studies , Harringtonines/administration & dosage , Harringtonines/adverse effects , Harringtonines/pharmacology , Hematologic Diseases/chemically induced , Homoharringtonine , Humans , Immunophenotyping , Leukemia, Myeloid, Accelerated Phase/pathology , Male , Middle Aged , Mitoxantrone/administration & dosage , Myeloid Cells/pathology , Neoplastic Stem Cells/pathology , Remission Induction , Young AdultABSTRACT
To evaluate the efficacy of interferon-α (IFN-α) combined with homoharringtonine (HHT) in the treatment of patients with newly diagnosed chronic-phase chronic myelogenous leukemia (CML), an IFN-α combined with HHT scheme was used as induction and maintenance therapy for 42 patients with CML in chronic phase. Thirty-five patients treated with IFN-α alone were used as the control group. It was found that the cytogenetic response rate and estimated 2-year survival rate were higher in the IFN-α + HHT group than in the IFN-α group (52.4% vs. 28.6% and 90% vs. 73%, respectively). No grade 3 or 4 hematological toxicity, severe infections, hemorrhage or non-hematological adverse reactions were observed. From this research it can be concluded that an IFN-α combined with HHT scheme is safe and effective for CML induction and long-term maintenance therapy. It may be a good choice for patients with CML who cannot accept a hematopoietic stem cell transplant and imatinib or who fail IFN-α therapy.
