Interferon should be discontinued at least 4 weeks 
prior to transplant to permit resolution of 
cytopenias. In most patients this should take no 
more than 4-6 weeks. 
5.2 Group 2 (accelerated, blast phase, > 1st chronic 
phase) : Cytoreductive Treatment Prior To Stem Cell 
Harvest 
1. Cytoreductive Chemotherapy * : 
Treatment of Accelerated Phase or Consolidation 
after Complete Remission from Blast Crisis: 
Daunorubicin 120 mg/m2 I.V. over 2 hours day 1 
Cytarabine 1.5 gm/m2 I.V. continuous infusion QD x 
4 days; may be repeated for patients in blast 
crisis who fail to achieve a complete remission 
with one cycle. Steroid eye drops will be used 
with cytarabine. 
Treatment of Blast Crisis: 
Tdt+ or suspected lymphoblastic blast phase may be 
treated initially with a vincristine/prednisone 
containing regimen at the discretion of the 
physician prior to aggressive consolidation with 
high dose cytarabine/daunorubicin and G-CSF. 
2 . G-CSF after Cytoreductive Chemotherapy: 
G-CSF 12 mcg/kg IV over 2 hours QD beginning day 5 
until the ANC exceeds 1000/mm3 on three 
consecutive days or a planned duration of 28 days. 
May restart G-CSF if ANC falls below 500/mm 3 . 
3 . Timing of Peripheral Blood Stem Cell Harvests For 
Patients in Complete Remission/Chronic Phase : 
Bone marrow aspirate and biopsy will be performed 
prior to peripheral blood stem cell collection to 
document complete remission/return to chronic 
phase status and cytogenetic status. Patients 
treated in blast crisis must have achieved a 
complete remission/return to chronic phase (see 
11.5) with one or two cycles of cytoreductive 
chemotherapy before proceeding to marrow harvest 
and transplant. 
4 . Peripheral Blood Stem Cell Collection : 
Recombinant DNA Research, Volume 16 
[159] 
