How does ASCT fit into the treatment of CML?
High-dose chemotherapy with allogeneic stem cell transplantation currently provides patients with CML the best chance of cure. Although some young patients are offered an allogeneic transplant as initial treatment, the majority will receive an allogeneic transplant only after failure of Gleevec. Patients too old to undergo allogeneic stem cell transplantation or those without an acceptable stem cell donor may also be treated with interferon and/or chemotherapy.High-dose chemotherapy and ASCT may represent an attractive treatment option for some patients unable or unwilling to undergo allogeneic stem cell transplantation after failure of Gleevec. This therapy may also be an alternative for patients who cannot tolerate or do not respond to alfa interferon treatment. The rationale behind high-dose chemotherapy and ASCT is that patients with CML usually retain substantial numbers of Philadelphia chromosome-negative stem cells in their blood and bone marrow. These stem cells can be collecte
