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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References
Bishop JF . The treatment of adult acute myeloid leukemia Semin Oncol 1997 24: 57–69
Woods WG, Kobrinsky N, Buckley JD et al. Timed-sequential induction therapy improves postremission outcome in acute myeloid leukemia: a report from the Children's Cancer Group Blood 1996 87: 4979–4989
Ravindranath Y, Yeager AM, Chang MN et al. Autologous bone marrow transplantation versus intensive consolidation chemotherapy for acute myeloid leukemia in childhood New Engl J Med 1996 334: 1428–1434
Appelbaum FR . Allogeneic hematopoietic stem cell transplantation for acute leukemia Semin Oncol 1997 24: 114–123
Körbling M, Hunstein W, Fliedner TM et al. Disease-free survival after autologous bone marrow transplantation in patients with acute myelogenous leukemia Blood 1989 74: 1898–1904
Löwenberg B, Abels J, van Bekkum DW et al. Transplantation of non-purified autologous bone marrow in patients with AML in first remission Cancer 1984 54: 2840–2843
McMillan AK, Goldstone AH, Linch DC et al. High-dose chemotherapy and autologous bone marrow transplantation in acute myeloid leukemia Blood 1990 76: 480–488
Labopin M, Gorin NC . Autologous bone marrow transplantation in 2502 patients with acute leukemia in Europe: a retrospective study Leukemia 1992 6: (Suppl. 4) 95–99
Chao NJ, Stein AS, Long GD et al. Busulfan/Etoposide – initial experience with a new preparatory regimen for autologous bone marrow transplantation in patients with acute nonlymphoblastic leukemia Blood 1993 81: 319–323
Zittoun RA, Mandelli F, Willemze R et al. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia New Engl J Med 1995 332: 217–223
Harousseau JL, Cahn JY, Pignon B et al. Comparison of autologous bone marrow transplantation and intensive chemotherapy as postremission therapy in adult acute myeloid leukemia. The Groupe Ouest Est Leucemies Aigues Myeloblastiques (GOELAM) Blood 1997 90: 2987–2986
Burnett AK, Goldstone AH, Stevens RMF et al. Randomized comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukaemia in first remission: result of MRC AML 10 trial Lancet 1998 351: 700–708
Yeager AM, Kaizer H, Santos GW et al. Autologous bone marrow transplantation in patients with acute nonlymphocytic leukemia, using ex vivo marrow treatment with 4-hydroperoxycyclophosphamide New Engl J Med 1986 315: 141–147
Ferrero D, DeFabritis P, Armadori S et al. Autologous bone marrow transplantation in acute myeloid leukemia after in vitro purging with an anti-lacto-n-fucopentaose III antibody and rabbit complement Leukemia Res 1987 11: 265–272
Rowley SD, Jones RJ, Piantadosi S et al. Efficacy of ex vivo purging for autologous bone marrow transplantation in the treatment of acute nonlymphoblastic leukemia Blood 1989 74: 501–507
Gorin NC, Aegerter P, Auvert B et al. Autologous bone marrow transplantation for acute myelocytic leukemia in first remission: a European survey of the role of marrow purging Blood 1990 75: 1606–1614
Selvaggi KJ, Wilson J, Mills LE et al. Improved outcome for high risk acute myeloid leukemia patients using autologous bone marrow transplantation and monoclonal antibody purged bone marrow Blood 1994 83: 1698–1705
Ball ED, Phelps V, Wilson J . Autologous bone marrow transplantation for acute myeloid leukemia in remission or first relapse using monoclonal antibody-purged marrow. In: Dicke KA, Keating A (eds) Autologous Marrow and Blood Transplantation Carden Jennings Publishing: Charlottesville, VA 1997 pp45–53
Ball ED, Graziano RF, Fanger MW . A unique antigen expressed on myeloid cells and acute leukemia blast cells defined by a monoclonal antibody J Immunol 1983 130: 2937–2941
Ball ED, Fanger MW . The expression of myeloid-specific antigens on myeloid leukemia cells: correlations with leukemia subclasses and implications for normal myeloid differentiation Blood 1983 61: 456–463
Sabbath KD, Ball ED, Larcom P et al. Heterogeneity of clonogenic cells in acute myeloblastic leukemia J Clin Invest 1985 75: 746–753
Howell AL, Fogg-Leach M, Davis BH, Ball ED . Continuous infusion of complement by an automated cell processor enhances cytoxicity of monoclonal antibody sensitized leukemia cells Bone Marrow Transplant 1989 4: 317–322
Howell AL, Ball ED . Monoclonal antibody-mediated cytotoxicity of human myeloid leukemia cells: an in vitro model for estimating efficiency and optimal conditions for cytolysis Blood 1985 66: 649–654
Armitage P, Berry G . Statistical Methods in Medical Research Blackwell Scientific Publishers: Boston, MA 1987
Collett D . Modelling Survival Data in Medical Research Chapman and Hall: London 1994
Miller CB, Rowlings PA, Jones RJ et al. Autotransplants for acute myelogenous leukemia (AML): effect of purging with 4-Hydroperoxycyclophosphamide (4 HC) Proc ASCO 1996 15: 338–000
Brenner MK, Rill DR, Moen RC et al. Gene-marking to trace origin of relapse after autologous bone marrow transplantation Lancet 1996 341: 85–86
Buckner CD, Clift RA . Clinical studies of allogeneic marrow transplantation in patients with acute nonlymphoblastic leukemia. Seattle Marrow Transplant team Bone Marrow Transplant 1989 3: (Suppl) 82
van Besian K, Przepiorka D, Mehra R et al. Impact of preexisting CNS involvement on the outcome of bone marrow transplantation in adult hematologic malignancies J Clin Oncol 1996 14: 3036–3042
Mrozek K, Heinonen K, de la Chapelle A et al. Clinical significance of cytogenetics in acute myeloid leukemia Semin Oncol 1997 24: 17–31
Barnard DR, Kalousek DK, Wiersma SR et al. Morphologic, immunologic, and cytogenetic classification of acute myeloid leukemia and myelodysplastic syndrome in childhood: a report from the Childrens Cancer Group Leukemia 1996 10: 5–12
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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DOI: https://doi.org/10.1038/sj.bmt.1702229
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