Disappearance of Ph1-positive cells in four patients with chronic granulocytic leukemia after chemotherapy, irradiation and marrow transplantation from an identical twin

N Engl J Med. 1979 Feb 15;300(7):333-7. doi: 10.1056/NEJM197902153000702.

Abstract

Four patients (21, 41, 13 and 38 years of age) with a history of chronic granulocytic leukemia for 12, 10, 11, and 106 months, respectively, were treated with dimethyl busulfan, cyclophosphamide, 920 rads of total-body irradiation and intravenous marrow infusion from normal, genetically identical twins. Serial chromosome analyses were performed on marrow aspirates cultured without mitotic stimulants. No Ph1-positive cells were detected in the marrows from the normal twins, whereas just before therapy, all 100 metaphases examined from each patient were Ph1-positive. Chromosome analyses were performed three to five times per patient after transplantation, and not a single Ph1-positive cell was detected. The patients remain hematologically normal 22, 23, 26 and 31 months after transplantation. The results show that the Ph1-positive clone can be eradicated by vigorous therapy and that the marrow in chronic granulocytic leukemia can be repopulated by stem cells from normal twins.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bone Marrow Transplantation*
  • Busulfan / therapeutic use
  • Child
  • Chromosomes, Human, 21-22 and Y*
  • Cyclophosphamide / therapeutic use
  • Female
  • Humans
  • Leukemia, Myeloid / genetics
  • Leukemia, Myeloid / radiotherapy
  • Leukemia, Myeloid / therapy*
  • Male
  • Pregnancy
  • Tissue Donors*
  • Transplantation, Homologous
  • Twins*
  • Twins, Monozygotic*

Substances

  • Cyclophosphamide
  • Busulfan