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Autografting For AML

Autologous bone marrow transplantation for acute myeloid leukemia in remission or first relapse using monoclonal antibody-purged marrow: results of phase II studies with long-term follow-up

Abstract

One hundred and thirty-eight patients with AML underwent ABMT with monoclonal antibody plus complement-purged marrow between August 1984 and March 1997. One hundred and ten patients were in CR (CR1: 23; CR2/3: 87) and 28 were in first relapse (R1) at ABMT. Preparative regimens included busulfan (16 mg/kg) and CY (120 mg/kg) (n = 93), CY (120 mg/kg over 2 days) with TBI (1200 cGy) (n = 35), and busulfan (16 mg/kg) plus etoposide (60 mg/kg) (n = 10). CR1 patients treated with CY/TBI (n = 7) had 3- and 5-year disease-free survival (DFS) rates of 71% and 57%. CR1 patients treated with BU/CY (n = 12), had 3- and 5-year DFS rates of 45%. Three and 5-year DFS for CR2/3 patients treated with CY/TBI (n = 26) was 23%. Three- and 5-year DFS for patients in CR2/3 treated with BU/CY (n = 55) was 31 and 28%. Three- and 5-year DFS for patients in R1 treated with BU/CY (n = 26) was 37%. In multivariate analysis, increased age was associated with greater risk of death and relapse. For CR2/3 patients, the length of CR1 was a significant predictor of DFS. ABMT performed in CR or R1 results in excellent 5-year DFS and OS. The contribution of purging may require a randomized trial comparing purged vs unpurged stem cell infusions. Bone Marrow Transplantation (2000) 25, 823–829.

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Acknowledgements

This work was supported by a grant CA31888 from the National Institutes of Health (EDB). We wish to acknowledge the contributions of the following physicians who supervised the treatment of patients at the participating institutions: Robert McMillan (Scripps Clinic and Research Foundation, La Jolla, CA), Letha Mills (Dartmouth-Hitchcock Medical Center, Lebanon, NH), David Hurd (Bowman Gray Medical Center, Winston-Salem, NC), Eric Martin (Medical Center of Delaware, Newark, DE), Roger Gingrich (University of Iowa Hospitals, Iowa City, IO), Matthew Carabasi (University of Alabama Medical Center, Birmingham, AL), Elizabeth Shpall (University of Colorado Health Science Center, Denver, CO), Charles August (Miami Children's Hospital, Miami, FL), Nayesh Kamani (University of Texas, San Antonio, TX), Aly Abdel-Mageed (University of Florida, Gainsville, FL), Robert Negrin (Stanford University, Palo Alto, CA), and David Friedman (Harris Methodist Hospital, Ft Worth, TX).

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Ball, E., Wilson, J., Phelps, V. et al. Autologous bone marrow transplantation for acute myeloid leukemia in remission or first relapse using monoclonal antibody-purged marrow: results of phase II studies with long-term follow-up. Bone Marrow Transplant 25, 823–829 (2000). https://doi.org/10.1038/sj.bmt.1702229

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