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[Autologous bone marrow transplantation for acute leukemia]
1First Department of Internal Medicine, Nagoya University School of Medicine.
Summary
Autologous bone marrow transplantation (ABMT) effectively treats high-risk acute lymphoblastic leukemia (ALL). Purged bone marrow cells improve disease-free survival, even in relapsed cases.
Area of Science:
- Hematology
- Oncology
- Immunology
Context:
- Acute lymphoblastic leukemia (ALL) is a significant hematologic malignancy.
- High-risk ALL presents therapeutic challenges.
- Autologous bone marrow transplantation (ABMT) is a potential treatment modality.
Purpose:
- To evaluate the efficacy of ABMT using purged bone marrow in patients with common acute lymphoblastic leukemia antigen (CALLA)-positive ALL.
- To assess disease-free survival (DFS) rates based on remission status and patient characteristics.
Summary:
- Twenty CALLA-positive ALL patients underwent ABMT with in vitro purged bone marrow cells.
- Conditioning regimens included cytarabine (CA), cyclophosphamide (CY), and total body irradiation (TBI), or melphalan and TBI for refractory cases.
- Disease-free survival was 81.8% at 2 years for patients in first complete remission (CR), and 40.0% for those in second CR.
Impact:
- ABMT with purged bone marrow demonstrates effectiveness in treating high-risk CALLA-positive ALL.
- The purging process successfully eliminated minimal residual bcr-abl mRNA in a Ph1 chromosome-positive case.
- This approach offers a viable therapeutic option for patients with challenging ALL prognoses.