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C Rosenfeld, RK Shadduck, D Przepiorka, KF Mangan and M Colvin
Department of Medicine, Montefiore Hospital, Pittsburgh, PA 15213.
Twenty-four patients with acute nonlymphocytic leukemia (ANLL) were treated
with high-dose chemotherapy or chemoradiotherapy followed by infusion of
autologous marrow purged with 100 micrograms/mL of 4-
hydroperoxycyclophosphamide (4HC). The marrow harvests were performed when
there were less than 5% blasts in the marrow. Seven patients were
transplanted in second complete remission (CR), eight in third CR, one in
fourth CR, and eight in early relapse. The median time to achieve 500
neutrophils/microL or 1,000 leukocytes/microL was 30 days. A platelet count
of 20,000/microL and 50,000/microL was achieved at a median of 67 and 91
days, respectively. One patient failed to engraft by day 58. There were
five other transplant-related deaths: sepsis (one), intracerebral
hemorrhage (one), veno-occlusive disease (one), and interstitial pneumonia
(two). Four of seven evaluable patients transplanted in early relapse
obtained a CR lasting 112, 143, 189, and greater than 615 days. Eight of 11
evaluable patients transplanted in CR have relapsed at a median of 153 days
(range, 104 to 311). The actuarial survival for all patients was 19%. There
was a trend toward improved relapse-free survival for patients transplanted
in remission as opposed to those transplanted in relapse (P = .11).
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| Copyright © 1989 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
