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Bone marrow purging with mafosfamide — A critical survey

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Summary

Autologous bone marrow transplantation (ABMT) is increasingly used to consolidate remissions, primarily in hematological disease. Various purging strategies have been developed to minimize the risk of reimplantation of tumor cells with the bone marrow autotransplant. Pharmacological purging with the oxazaphosphorine derivative mafosfamide has been studied extensively, and recent clinical data suggest that purging with mafosfamide may translate into superior remission duration if compared to nonpurged ABMT in acute leukemia. Chemical and experimental data relevant to mafosfamide-purging and clinical results are reviewed, with special emphasis on safety aspects.

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Abbreviations

ABMT:

autologous bone marrow transplantation

AL:

acute leukemia

AlDH:

aldehydedehydrogenase

ALL:

acute lymphoblastic leukemia

AML:

acute myelogenous leukemia

BFU-E:

erythrocyte burst forming units

CALLA:

common ALL antigen

CFU:

colony forming units

CFU-E:

erythrocyte CFU

CFU-GM:

granulocyte-macrophage CFU

CFU-Mix:

mixed CFU

CFU-Mk:

megakaryocyte CFU

CFU-S:

spleen CFU

CML:

chronic myelogenous leukemia

CP:

Cyclophosphamide

CR:

complete remission

DFP:

probability to remain disease free

DFS:

probability to survive disease free

EBMTG:

European bone marrow transplantation group

GM-CSF:

granulocyte-macrophage colony stimulating factor

GvHD:

graft versus host disease

ID-95:

dose inhibiting 95% of colony growth

OH-CP:

hydroxy-cyclophosphamide

OOH-CP:

hydroperoxy-cyclophosphamide

TBI:

total body irradiation

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  1. Department of Clinical Cancer Research, ASTA-Pharma AG, Weismüllerstrasse 45, D-6000, Frankfurt 1, Federal Republic of Germany

    H. Sindermann, M. Peukert & P. Hilgard

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Sindermann, H., Peukert, M. & Hilgard, P. Bone marrow purging with mafosfamide — A critical survey. Blut 59, 432–441 (1989). https://doi.org/10.1007/BF00349064

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