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Comparison of busulphan, hydroxyurea and allogeneic bone marrow transplantation (BMT) in chronic myeloid leukaemia:BMT prolongs survival
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Sciences.
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2004 In: The Hematology Journal, ISSN 15570285, Vol. 5, no 6, 462-466 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2004. Vol. 5, no 6, 462-466 p.
Identifiers
URN: urn:nbn:se:uu:diva-95819OAI: oai:DiVA.org:uu-95819DiVA: diva2:170168
Available from: 2007-04-25 Created: 2007-04-25Bibliographically approved
In thesis
1. Clinical and Experimental Studies in Chronic Myeloid Leukemia: Studies of Treatment Outcome, In Vitro Cellular Drug Resistance and Gene Expression
Open this publication in new window or tab >>Clinical and Experimental Studies in Chronic Myeloid Leukemia: Studies of Treatment Outcome, In Vitro Cellular Drug Resistance and Gene Expression
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aims of the studies described in the thesis were to investigate different treatment strategies in chronic myeloid leukemia (CML) patients. Furthermore, activity of imatinib was investigated by in vitro cytotoxicity assay, and the gene expression pattern in interferon treated patients.

In a randomized prospective national study, we examined the influence of busulphan (n=89) versus hydroxyurea (n=90) treatment on time to blast crisis, and survival. There was no significant difference in survival between hydroxyurea and busulphan treated patients; median survival was 3.5 and 3.2 years, respectively. The 26 patients who underwent allogeneic stem cell transplantation had a significantly longer median survival (4.7 years) than those who were not transplanted.

We investigated the feasibility of mobilizing Philadelphia chromosome negative blood stem cells with intensive chemotherapy and lenograstim in CML patients. Twenty-three patients (62%) were successfully mobilized. Twenty-one of these patients underwent autologous stem cell transplantation later on, with a 5-year overall survival at 68%.

Fluorometric Microculture Cytotoxicity Assay was used to analyze 32 tumor cell samples from CML patients, (26 chronic phase and 6 blast crisis). Imatinib showed a higher in vitro activity and more positive drug interactions in cells from blast crisis than from chronic phase. Interferon, daunorubicin and arsenic trioxide had the greatest benefit from a combination with imatinib.

Microarray-based gene expression analyses were performed on diagnostic CML samples prior to interferon treatment. We identified six genes that were differentially expressed in responders and non-responders to interferon. It might prove possible to use gene expression analysis to predict future response to interferon.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 256
Keyword
Medicine, chronic myeloid leukemia, adult, stem cell transplantation, mobilization of Ph-negative stem cells, in vitro assay, imatinib, gene expression, Medicin
Identifiers
urn:nbn:se:uu:diva-7841 (URN)978-91-554-6878-1 (ISBN)
Public defence
2007-05-16, Enghoffsalen, Akademiska Sjukhuset, Ingång 50, bv, Uppsala, 09:15
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Available from: 2007-04-25 Created: 2007-04-25Bibliographically approved

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