Autologous bone marrow transplantation with 4-hydroperoxycyclophosphamide-purged marrow for acute lymphoblastic leukemia
| Autor: | Elana J. Bloom, Rowena Gonzales‐Chambers, Kenneth F. Mangan, Craig S. Rosenfeld, Dennis Borochovitz, Richard K. Shadduck, Donna Przepiorka, O. Michael Colvin |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male Cancer Research Vincristine medicine.medical_specialty Adolescent medicine.medical_treatment Gastroenterology Bone Marrow Acute lymphocytic leukemia Internal medicine medicine Humans Cyclophosphamide Bone Marrow Transplantation Chemotherapy business.industry Macrophages Stem Cells Remission Induction Total body irradiation Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Surgery Transplantation Survival Rate medicine.anatomical_structure Oncology Pediatrics Perinatology and Child Health Absolute neutrophil count Female Bone marrow Neoplasm Recurrence Local business Ex vivo Whole-Body Irradiation medicine.drug Follow-Up Studies Granulocytes |
| Zdroj: | Medical and pediatric oncology. 19(3) |
| ISSN: | 0098-1532 |
| Popis: | Ten patients age 13-52 years with acute lymphoblastic leukemia (ALL) in first complete remission (CR) (1), second CR (6), or relapse (3) were treated with cyclophosphamide 50 mg/kg daily x 4 and total body irradiation 3 Gy daily x 4 followed by infusion of autologous marrow purged with 4-hydroperoxycyclophosphamide (4-HC) at 100-120 micrograms/ml. The patients transplanted in relapse also received 2 mg vincristine and corticosteroids. All marrows were harvested while patients were in CR. The nucleated marrow cell dose was 3.5 +/- 0.7 x 10(8)/kg, and the CFU-GM content of the transplant was 0.4 +/- 0.5 x 10(3)/kg after purging with 4-HC. Median time from transplantation is 48 months. The neutrophil count (ANC) exceeded 1.0 x 10(9)/L at a median of 26 days and platelets exceeded 50 x 10(9)/L at 34 days. All patients were in remission after transplantation (ABMT). Five patients relapsed 2-9 months after ABMT (actuarial rate 60%). Three patients are alive and in CR at 17+, 43+, and 54+ months after ABMT. Purging marrow with 4-HC did not adversely affect engraftment, but it is not clear if the high relapse rate was due to incomplete ex vivo purging or inadequacy of the conditioning regimen. |
| Databáze: | OpenAIRE |
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