Autologous bone marrow transplantation in leukemia

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Autologous bone marrow transplantation (ABMT) is a viable alternative to conservative treatment for recurrent malignancies in patients lacking HLA-identical donors.
• High-dose chemotherapy and radiotherapy are used for hematopoietic reconstitution post-ABMT.
• Eliminating clonogenic tumor cells from bone marrow grafts remains challenging for solid tumors and leukemia.

Purpose of the Study:

• To evaluate the efficacy of autologous bone marrow transplantation using cryopreserved bone marrow treated with specific antisera for hematopoietic reconstitution.
• To assess the potential of antibody-based purging of residual leukemic cells in ABMT for acute lymphoblastic leukemia (ALL).

Main Methods:

• Bone marrow was aspirated from 50 children with acute lymphoblastic leukemia in remission and cryopreserved.
• Samples were preserved for 1-60 months, with a mean nucleated cell count of 4 X 10(8)/kg.
• In five patients with common ALL (cALL), ABMT was performed using bone marrow incubated with specific antisera targeting cALL cells.

Main Results:

• Cryopreserved bone marrow samples showed 80%-100% stem cell viability.
• Treatment with specific antisera effectively targeted and eliminated residual leukemic cells.
• ABMT stimulated bone marrow repopulation and hematopoietic regeneration in treated patients.

Conclusions:

• Autologous bone marrow transplantation, utilizing cryopreserved and antibody-purged bone marrow, is a promising approach for hematopoietic reconstitution.
• Antibody-mediated purging of residual leukemic cells in ABMT shows potential without compromising regenerative capacity.
• This method offers a potential strategy for managing recurrent malignancies, particularly in pediatric ALL.