Bone marrow transplantation for Philadelphia-chromosome-positive acute lymphoblastic leukemia

TY - JOUR

T1 - Bone marrow transplantation for Philadelphia-chromosome-positive acute lymphoblastic leukemia

AU - Stockschläder, M

AU - Hegewisch-Becker, S

AU - Krüger, W

AU - tom Dieck, A

AU - Mross, K

AU - Hoffknecht, M

AU - Berger, C

AU - Kohlschütter, B

AU - Martin, H

AU - Peters, Stefan

PY - 1995/11

Y1 - 1995/11

N2 - The outcome of 14 bone marrow transplants (BMT) (autologous 4; allogeneic 10) for Philadelphia-chromosome (Ph1) positive acute lymphoblastic leukemia (ALL) was analyzed. Preparative regimens consisted of etoposide (VP16) (30 or 45 mg/kg BW) (n = 14), cyclophosphamide (CY)(120 mg/kg BW) (n = 14), and total body irradiation (TBI)(12 Gy) (n = 13) or busulfan (Bu)(16 mg/kg) (n = 1). All patients receiving autologous marrow were in complete remission (CR) (three patients in 1.CR, one patient in 2.CR) at the time of BMT. For allogeneic BMT (nine related, one unrelated donor), seven patients were in first CR, two patients in first refractory relapse, and one patient in second relapse. With a median follow-up of 503 days (range 93-1522 days), eight out of 14 patients are alive in remission (six out of 10 patients receiving allogeneic, and two out of four patients receiving autologous BMT). Disease-free survival for all patients is 46%. Causes of death were relapse (n = 3) and transplant-related toxicity (n = 3). All patients tested for the bcr/abl rearrangement by reverse transcriptase-polymerase chain reaction (RT-PCR) were negative 4 weeks post-BMT. Two of the three patients who subsequently relapsed were repeatedly RT-PCR positive prior to relapse (test not done in the third). Considering the negligible cure rate of Ph1-positive ALL with conventional chemotherapy regimens, our data support the concept of early (> or = 1 CR) BMT (allogeneic > autologous (purged) following triple therapy with TBI, VP16, and CY.

AB - The outcome of 14 bone marrow transplants (BMT) (autologous 4; allogeneic 10) for Philadelphia-chromosome (Ph1) positive acute lymphoblastic leukemia (ALL) was analyzed. Preparative regimens consisted of etoposide (VP16) (30 or 45 mg/kg BW) (n = 14), cyclophosphamide (CY)(120 mg/kg BW) (n = 14), and total body irradiation (TBI)(12 Gy) (n = 13) or busulfan (Bu)(16 mg/kg) (n = 1). All patients receiving autologous marrow were in complete remission (CR) (three patients in 1.CR, one patient in 2.CR) at the time of BMT. For allogeneic BMT (nine related, one unrelated donor), seven patients were in first CR, two patients in first refractory relapse, and one patient in second relapse. With a median follow-up of 503 days (range 93-1522 days), eight out of 14 patients are alive in remission (six out of 10 patients receiving allogeneic, and two out of four patients receiving autologous BMT). Disease-free survival for all patients is 46%. Causes of death were relapse (n = 3) and transplant-related toxicity (n = 3). All patients tested for the bcr/abl rearrangement by reverse transcriptase-polymerase chain reaction (RT-PCR) were negative 4 weeks post-BMT. Two of the three patients who subsequently relapsed were repeatedly RT-PCR positive prior to relapse (test not done in the third). Considering the negligible cure rate of Ph1-positive ALL with conventional chemotherapy regimens, our data support the concept of early (> or = 1 CR) BMT (allogeneic > autologous (purged) following triple therapy with TBI, VP16, and CY.

KW - Adult

KW - Aged

KW - Bone Marrow Transplantation/adverse effects

KW - Child

KW - Child, Preschool

KW - Female

KW - Fusion Proteins, bcr-abl/genetics

KW - Humans

KW - Hyperbilirubinemia/etiology

KW - Male

KW - Middle Aged

KW - Neoplasm, Residual

KW - Philadelphia Chromosome

KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics

KW - RNA, Messenger/analysis

KW - Survival Rate

M3 - SCORING: Journal article

C2 - 8547863

VL - 16

SP - 663

EP - 667

JO - BONE MARROW TRANSPL

JF - BONE MARROW TRANSPL

SN - 0268-3369

IS - 5

ER -