Mobilization of CD34+CD38- hematopoietic stem cells after priming in acute myeloid leukemia

Table 1 Characteristics at diagnosis and outcome of the 8 acute myeloid leukemia patients

Pts	Age(yr)	Sex	Cytogenetics	CD34+(%)1	FAB	Molecular Biology2	WBC(x 109/l)2	Risk-group	G-CSFpriming	BM 15 d	CR	Consolidationand DFS
1	59	M	Normal	85	M5	Flt3-ITD neg CEBPA pos	55.1	Favorable intermediate	Yes	No blast	Yes	Chemotherapy 15+ mo
2	35	M	Normal	85	M2	Flt3-ITD neg CEBPA pos	4.8	Favorable intermediate	Yes	No blast	Yes	Chemotherapy 16+ mo
3	56	F	+8, del (20) (q11; q13)	93	M1	Flt3-ITD pos	12.6	Poor intermediate	Yes	ND	Yes	Chemotherapy 3 mo
4	19	M	Normal	67	M6	Flt3-ITD pos MLL pos	0.9	Unfavorable	Yes	ND	Yes	AlloSCT 6 mo
5	55	M	Normal	8	M1	Flt3-ITD pos NPM1 pos	147.3	Poor intermediate	Yes	ND	Yes	AlloSCT 14+ mo
6	55	F	Normal	3	M5	Flt3-ITD neg Evi-1 pos	3.7	Unfavorable	No	5% blasts	Yes	AlloSCT 14+ mo
7	44	M	Complex	94	M0	Flt3-ITD neg NPM1 neg	1.4	Unfavorable	No	> 5% blasts	No3	AlloSCT 11 mo
8	45	F	–7, +21	83	M4	Flt3-ITD neg NPM1 neg	2.4	Unfavorable	No	No blast	Yes	AlloSCT11+ mo

¹Expression of CD34 by leukemic cells;

²Molecular biology and WBC count at diagnosis;

³Morphological complete remission was subsequently achieved by salvage therapy combining idarubicin with high-dose cytarabine. Patients prognosis was defined according to the following classification based on cytogenetics and molecular marker analyses. Karyotype abnormalities that involved core binding factor (CBF) leukemias [t (16; 16) (p13; q22), inv (16) (p13; q22), or t (8; 21) (q22; q22)] with or without other cytogenetic abnormalities were considered favorable cytogenetics. Monosomies or deletions of chromosomes 5 and 7; abnormalities of the long arm of chromosome 3 (or Evi-1 gene mutation); 11q23 abnormality (or MLL gene mutation); or complex cytogenetic abnormalities (defined as at least five unrelated cytogenetic clones) were considered unfavorable risk factors. Other cytogenetic abnormalities and cytogenetically normal (CN)-AML were designated intermediate risk factors. Intermediate-risk cytogenetics was further subdivided into a favorable intermediate risk group [CN-AML with nucleophosmin (NPM1) or CCAAT/enhancer-binding protein-(CEBPA) mutations and no FLT3-ITD] and a poor intermediate risk group (other patients). Induction chemotherapy consisting of a TSC including a first sequence combining daunorubicin, 60 mg/m² per day IV on 1–3 d, and cytarabine, 500 mg/m² per day IV over the same period. The second sequence, administered after 4 d free interval, consisted of daunorubicin, 35 mg/m2 per day, IV on 8 d and 9 d, and cytarabine, 1000 mg/m² per 12 h on 8–10 d. Five patients received G-CSF (filgrastim) priming (5 μg/Kg per day) on 1 to 10 d. Three patients were not primed with G-CSF. AlloSCT: Allogeneic stem cell transplantation; BM: Bone marrow; CR: Morphological complete remission; DFS: Disease-free survival; F: Female; FAB: French-American-British morphological classification; M: Male; neg: Negative; pos: Positive; Pts: Patients; WBC: White blood cell; G-CSF: Granulocyte Colony-Stimulating Factor.