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Autologous bone marrow transplantation with 4-hydroperoxycyclophosphamide purged marrows for children with acute non-lymphoblastic leukemia in second remission.

Abstract
Although autologous bone marrow transplantation (ABMT) following purging with 4-hydroperoxycyclophosphamide (4HC) has been effective for some adults with acute non-lymphoblastic leukemia (ANLL), there are few data on ABMT for children. We have performed ABMT for 13 patients (median age, 5 years) with ANLL in second remission. Bone marrow was treated ex vivo with 4HC to kill residual leukemic cells. In order to enhance the anti-leukemic effect of 4HC, exogenous red blood cells were eliminated from the marrow/4HC mixture. All patients were conditioned for transplantation with busulfan (16 mg/kg) and cyclophosphamide (200 mg/kg), followed by infusion of the 4HC treated marrow. Eleven of 13 patients had complete hematologic reconstitution; there were no transplant-related deaths. Five patients relapsed at 2, 4, 5, 6 and 6 months post-BMT. Eight patients are disease-free survivors; the median time for survival is 24 months, with a projected disease-free survival of 61%. ABMT is a safe and efficacious treatment modality for children with ANLL in second remission. Our results suggest that the disease-free survival for pediatric patients may be superior to that seen in adults.
AuthorsC Lenarsky, K Weinberg, J Petersen, J Nolta, J Brooks, G Annett, D Kohn, R Parkman
JournalBone marrow transplantation (Bone Marrow Transplant) Vol. 6 Issue 6 Pg. 425-9 (Dec 1990) ISSN: 0268-3369 [Print] England
PMID2097012 (Publication Type: Journal Article)
Chemical References
  • Cyclophosphamide
  • Busulfan
  • perfosfamide
Topics
  • Actuarial Analysis
  • Adolescent
  • Adult
  • Bone Marrow Transplantation (methods)
  • Busulfan (administration & dosage)
  • Child
  • Child, Preschool
  • Cyclophosphamide (administration & dosage, analogs & derivatives, pharmacology, therapeutic use)
  • Evaluation Studies as Topic
  • Graft Survival
  • Humans
  • Infant
  • Leukemia, Myeloid, Acute (pathology, surgery)
  • Neoplastic Stem Cells (drug effects)
  • Remission Induction
  • Transplantation, Autologous

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