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Pediatric Transplants

Autologous purified peripheral blood SCT in childhood low-risk relapsed ALL

Bone Marrow Transplantation volume 46, pages 217–226 (2011)Cite this article

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Abstract

The treatment of childhood B-cell-precursor ALL after isolated-extramedullary or late relapse is controversial. Most approaches are based on chemotherapy or allogeneic transplantation. The aim of this report is to assess the long-term outcome of children with ‘low-risk’ relapsed ALL treated according to a prospective purified auto-transplantation protocol. From January 1997 to March 2004, at a single pediatric Center, 30 ALL consecutive children, lacking an HLA-identical sibling, were treated according to the autologous purified peripheral blood stem cell protocol after isolated-extramedullary (7) or late medullary (24) relapse. After the ‘DIAVE’ mobilizing regimen a median of 11.6 × 106CD34+/Kg (range 3.9–27.4) were collected. Leukaphereses were depleted by 99% of CD19+cells (range 98–100) by means of a double step immunological purification. The conditioning regimen included TBI. No early severe complications nor transplant-related deaths occurred; late effects, as expected, mostly consisted in endocrinological issues and were assessed at a median follow-up of 8.5 years. Five-year-EFS and survival were 68.5% (s.e. 7.9) and 85.7% (s.e. 5.9), respectively, for the 35 eligible patients and 70.0% (s.e. 8.4) and 86.7% (s.e. 6.2) for the 30 patients actually transplanted as per protocol. The outcome of this series favorably compares with historical data regarding both autologous transplantation and standard salvage chemotherapy.

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Acknowledgements

We thank Emanuela Marrocco for data management, Andreina di Palma for secretarial assistance, the Comitato Maria Letizia Verga per lo studio e la cura della leucemia del bambino, the Fondazione Matilde Tettamanti and the Comitato Stefano Verri for their continuous support. This work has been partly supported by grants from AIRC (Associazione Italiana Ricerca sul Cancro) and MIUR (Ministero dell’Istruzione, dell’Università e della Ricerca) to AB and MGV as well as by grants from the Regione Lombardia and the Fondazione Cariplo to AB.

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  1. Clinica Pediatrica, Università degli Studi di Milano Bicocca, Monza, Italy

    A Balduzzi, S Bonanomi, G Gaipa, S Songia, O Maglia, V Rossi, S Motta, L Di Maio, C Uderzo, V Conter, A Rovelli & A Biondi

  2. Dipartimento di Medicina Clinica e Prevenzione, Università degli Studi di Milano Bicocca, Monza, Italy

    M G Valsecchi & S Galimberti

  3. Servizio Immunologia e Trasfusionale, Ospedale San Gerardo, Monza, Italy

    P Perseghin & M Dassi

  4. Pädiatrische Onkologie/Hämatologie, Charité, Humboldt Universität, Berlin, Germany

    G Henze & A von Stackelberg

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Correspondence to A Balduzzi.

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Balduzzi, A., Bonanomi, S., Valsecchi, M. et al. Autologous purified peripheral blood SCT in childhood low-risk relapsed ALL. Bone Marrow Transplant 46, 217–226 (2011). https://doi.org/10.1038/bmt.2010.85

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