Autologous Bone Marrow Transplantation in Relapsed Adult Acute Leukemia

Dicke, Karel A.; Zander, Axel R.; Spitzer, Gary; Verma, Dharmvir S.; Peters, Lester J.; Vellekoop, Lijda; Thomson, Stephen P.; Stewart, Dennis A.; McCredie, Kenneth B.

doi:10.1007/978-3-642-67319-1_26

Cited by 35 publications

(13 citation statements)

References 11 publications

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“…27 Satisfactory antileukemic effects have long been described for TBI, in combination with piperazinedione, in adults with primary refractory acute leukemia in a series of reports. 4,[28][29][30][31][32] However, at that time the authors made no claims for the regimen because of the paucity of data on alternative regimens. Mengarelli et al 8 in their recent study noted that the 'alternative regimens' used in refractory acute leukemia did not improve the outcome profiles for these patients.…”

Section: Discussionmentioning

confidence: 99%

Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up

Oyekunle

Kröger

Zabelina

et al. 2005

Bone Marrow Transplant

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We examined retrospectively 44 patients with refractory acute leukemia (acute myeloid leukemia (AML)/acute lymphoblastic leukemia ¼ 25/19) who underwent allogeneic transplantation at our center between 11/1990 and 04/2004. The median leukemic blasts was 25% and age 28 years (range, 3-56). Twenty-one patients had untreated relapse, 13 failed reinduction, eight in partial remission and two aplastic. Conditioning was myeloablative using cyclophosphamide, busulfan, total-body irradiation and etoposide (Bu/Cy/VP, n ¼ 22; TBI/Cy/VP, n ¼ 17; others, n ¼ 5) followed by marrow or peripheral blood transplant (n ¼ 23/21) from unrelated or related donors (n ¼ 28/16). All patients had graft-versus-host disease (GVHD) prophylaxis with cyclosporin and methotrexate. One patient experienced late graft failure. Severe acute-GVHD and chronic-GVHD appeared in eight and 14 patients, respectively. Thirteen patients (30%) remain alive after a median of 25.3 months (range, 2.4-134.1); with 31 deaths, mostly from relapse (n ¼ 15) and infections (n ¼ 12). Overall survival (OS) and progression-free survival (PFS) at 5 years was 28 and 26%, respectively. OS and PFS were significantly better with blasts p20% and time to transplant p1 year while transplant-related mortality was less with the use of TBI. We conclude that patients with refractory leukemia can benefit from allogeneic BMT, especially with p20% marrow blast.

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Section: Discussionmentioning

confidence: 99%

Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up

Oyekunle

Kröger

Zabelina

et al. 2005

Bone Marrow Transplant

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“…our group initiated a study of autologous bone transplantation (ABMT) in relapsed acute leukemia using piperazinedione and TBI [36]. We treated 19 patients in first or second relapse.…”

Section: Results Of Transplantation In Aml With Nonpurged Marrow Cellsmentioning

confidence: 99%

“…5 (45%) out of 11 pa tients achieved CR with a median response duration of 4 months, varying from 2 to 14 months [36], In another study by our group, the CBV regimen was used in a comparable patient population. 4 (33%) out of 12 pa tients achieved CM ranging from 1 to 7 months [40], With this last regimen, no early mortality was noted.…”

Section: Autologous Bone Marrow Transplantation In Acute Lymphocytic mentioning

confidence: 99%

“…Gradient cen trifugation of bone marrow cells using dis continuous albumin gradients removes up to 90% of the leukemic cells [42]. Gradient cen trifugation of the bone marrow cells had no biological bearing in vivo on prolongation of remission when used in patients in relapse [36], Our group incorporated high dose chemo therapy with ABMT in the treatment of ALL as an intensification treatment in first remis sion [44]. After the patients reached full re mission, consolidation with the same regi men was given.…”

Section: The Role Of Purging In Autologous Bone Marrow Transplantatiomentioning

confidence: 99%

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Autologous Bone Marrow Transplantation in Acute Leukemia

Dicke¹,

Vellekoop²,

Zander³

et al. 1985

Pathol Immunopathol Res

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“…The major limit of ABMT is the presence of contaminating malignant cells in remission marrow, able to deter mine the relapse of disease. To overcome this obstacle, several approaches to purge marrow of tumor cells have been suggested [7][8][9][10][11][12], In our patients with acute leukemia (AL) we used mafosfamide (Asta-Z) to destroy ex vivo residual malignant clonogenic cells from marrow before the reinfusion. …”

Section: Introductionmentioning

confidence: 99%

Autologous Bone Marrow Transplantation in Acute Leukemia

et al. 1987

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We evaluated the therapeutic efficacy of autologous bone marrow transplantation (ABMT) in 49 patients with acute leukemia, using ex-vivo-treated marrow with mafosfamide. This report summarizes data collected from 8 Italian centers, involving 27 cases with acute lymphoid leukemia (ALL) and 22 cases with acute nonlymphoid leukemia (ANLL). The analysis of the results shows that the disease-free survival of ALL and ANLL are similar (45 and 52%, respectively) and no significant difference can be demonstrated between patients transplanted in CR1 or CR2, although there is a trend in favor of ABMT in CR1

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Autologous Bone Marrow Transplantation in Relapsed Adult Acute Leukemia

Cited by 35 publications

References 11 publications

Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up

Allogeneic stem-cell transplantation in patients with refractory acute leukemia: a long-term follow-up

Autologous Bone Marrow Transplantation in Acute Leukemia

Autologous Bone Marrow Transplantation in Acute Leukemia

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