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Limited Success with a Postremission Strategy Comprising Conventional Consolidation and High-Dose Treatment (HDT) with Autologous Peripheral Progenitor Cell (PBPC) Support for Adult Acute Lymphoblastic Leukaemia (ALL)

  • R. Bassan
  • E. Di Bona
  • A. Rohatiner
  • E. Pogliani
  • G. Rossi
  • A. Porcellini
  • P. Fabris
  • G. Lambertenghi-Deliliers
  • T. Lerede
  • A. D′Emilio
  • A. Rambaldi
  • T. A. Lister
  • T. Barbui
Conference paper
Part of the Haematology and Blood Transfusion Hämatologie und Bluttransfusion book series (HAEMATOLOGY, volume 41)

Abstract

The introduction of PBPC support as a means to hasten rapid and effective autologous recovery following myelosuppressive therapy has greatly broadened the indications for HDT in haematological malignancies (Juttner et al. 1994). Experience with HDT-PBPC is very limited in ALL. One quoted advantage of using autologous PBPC is that, when desired, post-graft chemotherapy can be more easily delivered compared to a marrow autograft (Powles et al. 1995, Singhal et al. 1997). Conversely, a problem is the reinfusion of residual lymphoid blast cells cells (Nagafuji et al. 1993, van Rhee et al. 1995, Seriu et al. 1995). The main aim of this collaborative study (07/93), which was conducted between 1993 and 1995 (up to 1999 at one centre), was to evaluate the role of HDT supported by autologous PBPC as consolidation of first remission in adults with ALL. No purging procedure of the blood cell autograft was adopted. It was hoped, in patients completing the HDT phase, to further evaluate the role of post-graft maintenance chemotherapy. The long-term results of this programme as applied to an unselected series of 91 adults are reviewed below.

Keywords

Overall Survival Acute Lymphoblastic Leukemia Acute Lymphoblastic Leukaemia Total Body Irradiation Allogeneic Haematopoietic Stem Cell Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Bassan R, Rohatiner AZS, Lerede T et al. (2000) Role of early anthracycline dose-intensity according to expression of Philadelphia chromosome/BCR-ABL rearrangements in B-precursor adult acute lymphoblastic leukemia. Hematol J 1:226–234PubMedCrossRefGoogle Scholar
  2. Bassan R, Rohatiner AZS, Lerede T et al. (2000) Role of early anthracycline dose-intensity according to expression of Philadelphia chromosome/BCR-ABL rearrangements in B-precursor adult acute lymphoblastic leukemia. Hematol J 1:226–234PubMedCrossRefGoogle Scholar
  3. Camara R, Granados E, Gil JJ et al. (1998) Bone marrow transplantation in acute lymphoblastic leukemia (ALL): comparison of busulfan vs total body irradiation (TBI) as conditioning. Bone Marrow Transplant 21 (suppl 1):S102Google Scholar
  4. Cuttner J, Mick R, Budman DR et al. (1991) Phase III trial of brief intensive treatment of adult acute lymphocytic leukemia comparing daunorubicin and mitoxantrone: a CALGB study. Leukemia 5:425–431PubMedGoogle Scholar
  5. Dekker AW, van’t Veer MB, Sizoo W et al. (1997) Intensive postremission chemotherapy without maintenance therapy in adults with acute lymphoblastic leukemia. J Clin Oncol 15:476–482PubMedGoogle Scholar
  6. Juttner CA, Fibbe WE, Nemunaitis J et al. (1994) Blood cell transplantation: report from an International Consensus Meeting. Bone Marrow Transplant 14:689–693PubMedCrossRefGoogle Scholar
  7. Nagafuji K, Harada M, Takamatsu Y et al. (1993) Evaluation of leukaemic contamination in peripheral blood stem cell harvests by reverse transcriptase polymerase chain reaction. Br J Haematol 85:578–583PubMedCrossRefGoogle Scholar
  8. Powles R, Mehta J, Singhal S et al. (1995) Autologous bone marrow or peripheral blood stem cell trans-plantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center. Bone Marrow Transplant 16:241–247PubMedGoogle Scholar
  9. Rambaldi A, Borleri G, dotti G et al. (1998) Innovative two-step negative selection of granulocyte colony-stimulating factor-mobilized circulating progenitor cells: adequacy for autologous and allogeneic transplantation; Blood 91:2189–2196PubMedGoogle Scholar
  10. Ringdén O, Labopin M, Tura S et al. (1996) A comparison of busulphan versus total body irradiation combined with cyclophosphamide as conditioning for autograft or allograft bone marrow transplantation in patients with acute leukaemia. Br J Haematol 93:637–645PubMedCrossRefGoogle Scholar
  11. Seriu T, Yokota S, Nakao M et al. (1995) Prospective monitoring of minimal residual disease during the course of chemotherapy in patients with acute lymphoblastic leukemia, and detection of contaminating tumor cells in peripheral blood stem cells for autotransplantation. Leukemia 9: 615–623PubMedGoogle Scholar
  12. Singhal S, Powles R, Treleaven J et al. (1997) Sequential high-dose therapy of acute lymphoblastic leukemia in adult patients: long-term follow-up. Blood 90 (suppl 1):235aGoogle Scholar
  13. van Rhee F, Marks DI, Lin F et al. (1995) Quantification of residual disease in philadelphia-positive acute lymphoblastic leukemia: comparison of blood and bone marrow. Leukemia 9:329–335PubMedGoogle Scholar
  14. Stryckmans P, De Witte Th, Marie JP et al. (1992) Therapy of adult ALL: overview of 2 successive EORTC studies: (ALL-2 & ALL-3). Leukemia 6 (suppl 2):199–203PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • R. Bassan
    • 1
  • E. Di Bona
    • 2
  • A. Rohatiner
    • 3
  • E. Pogliani
    • 4
  • G. Rossi
    • 5
  • A. Porcellini
    • 6
  • P. Fabris
    • 7
  • G. Lambertenghi-Deliliers
    • 8
  • T. Lerede
    • 1
  • A. D′Emilio
    • 2
  • A. Rambaldi
    • 1
  • T. A. Lister
    • 3
  • T. Barbui
    • 1
  1. 1.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atOspedali RiunitiBergamoItaly
  2. 2.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atOspedale CivileVicenzaItaly
  3. 3.ICRF Medical Oncology UnitSt. Bartholomew’s HospitalLondonUK
  4. 4.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atOspedale San GerardoMonzaItaly
  5. 5.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atSpedali CiviliBresciaItaly
  6. 6.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atOspedale CivileCremonaItaly
  7. 7.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atOspedale CivileBolzanoItaly
  8. 8.From Department/Division/Unit of Haematology/Haematopoietic stem cell transplantation atOspedale MaggioreMilanoItaly

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