CHRONIC GRANULOCYTIC LEUKEMIA - CYTOGENETIC CONVERSION OF BONE-MARROW WITH CYCLE-SPECIFIC CHEMOTHERAPY

Abstract

Sixteen patients with Ph1[Philadelphia chromosome]-positive chronic granulocytic leukemia (CGL) were entered on a pulsing chemotherapy program consisting of cytosine arabinoside 100 mg/m2 per day .times. 5 and thioguanine 100 mg/m2 per day .times. 5 every 21 days in an attempt to convert the Ph1-positive marrow to a Ph1-negative state and achieve a complete remission. Twelve patients had an adequate trial of drug treatment, and 10 of these had adequate chromosome examinations. There were 2 conversions, one of which was maintained for 5+ mo., while the other was transient. The program was unacceptable to most patients due to intolerable nausea and vomiting. A prospective chemotherapeutic attempt to convert Ph1-positive marrow without splenectomy induced conversion in 2 of 10 patients. Other regimens which might induce less nausea and vomiting and a higher rate of conversions should be sought in future attempts to alter the invariably fatal outcome of CGL.