Autologous bone marrow transplantation (ABMT) for acute leukaemia in complete remission: a pilot study of 33 cases
- 1 July 1986
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 63 (3) , 457-470
- https://doi.org/10.1111/j.1365-2141.1986.tb07522.x
Abstract
Thirty-three leukaemic patients in CR were treated by high-dose therapy followed by ABMT: 18 of them had acute non-lymphoblastic leukaemia (ANLL) in first remission (CR1) with a mean age of 23.7 years (3-44). All but one of them were conditioned with a polychemotherapy regimen including 6-thioguanine, Ara-C, CCNU, and cyclophosphamide. The marrow cells were purged by chemical means in 16 cases. Five transplant-related deaths were observed: three cardiac failures, one interstitial pneumonitis and one aspergillus pneumonia. At the time of analysis (October 1984), four patients had relapsed and eight were still in unmaintained CR1 (44+, 46+, 30+, and five between 2.5+ and 8+ months post transplant). Fifteen patients had acute lymphoblastic leukaemia: four were autografted in CR1 and 11 children were grafted in CR2; the conditioning regimen was fractionated total body irradiation followed by cyclophosphamide for all but one patient who was conditioned with BACT (Burkitt leukaemia); the marrow was purged by a chemical agent in 11 patients and by monoclonal antibodies and C''in four: four out of 15 patients relapsed (two grafted in CR1 and two grafted in CR2); 10 patients are still in unmaintained CR: two adults grafted in CR1 (26+; 12+ months) and eight children with a mean follow-up of 13.4 months postgraft (2+-45+ months). The clinical study leads to the following conclusions: in adult patients the marrow should be harvested during CR1 and at the time of minimal residual disease. The quality of previous chemotherapy and conditioning regimen prior to ABMT play a prominent role in the in vivo eradication of the leukaemic cells. The real impact of marrow purging is still unknown and a larger series of homogeneous patients, ocnditioned with the same protocols and the same transplant timing, is required before any conclusions can be drawn.This publication has 36 references indexed in Scilit:
- Recent Advances in the Biology and Treatment of Acute Lymphoblastic Leukemia in AdultsNew England Journal of Medicine, 1984
- Bone marrow transplantation for acute lymphoblastic leukaemia: a survey of the European Group for Bone Marrow Transplantation (E.G.B.M.T.)British Journal of Haematology, 1984
- Repeated high-dose cyclophosphamide, BCNU and VP-16-213 and autologous bone marrow transplantation in adult acute lymphocytic leukemia in first remissionEuropean Journal of Cancer and Clinical Oncology, 1984
- Méthode de concentration des cellules-souches médullaires utilisant le laveur IBM 2991: Préalable essentiel avant traitement in vitro de la moelle osseuse par des moyens pharmacologiques ou immunologiquesRevue Française de Transfusion et Immuno-hématologie, 1983
- IMMUNOMAGNETIC REMOVAL OF CALLA POSITIVE CELLS FROM HUMAN BONE MARROWThe Lancet, 1983
- 4‐Hydroperoxyclophosphamide: a model for eliminating residual human tumour cells and T‐lymphocytes from the bone marrow graftBritish Journal of Haematology, 1982
- AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN CALLA-POSITIVE ACUTE LYMPHOBLASTIC LEUKAEMIA AFTER IN-VITRO TREATMENT WITH J5 MONOCLONAL ANTIBODY AND COMPLEMENTThe Lancet, 1982
- A technique for rapid isolation of bone marrow mononuclear cells using Ficoll‐Metrizoate and the IBM 2991 blood cell processorBritish Journal of Haematology, 1982
- Cardiotoxicity associated with high-dose cyclophosphamide therapyArchives of internal medicine (1960), 1981
- AUTOLOGOUS BONE-MARROW TRANSPLANTATION IN RELAPSED ADULT ACUTE LEUKÆMIAThe Lancet, 1979