Autologous bone marrow transplantation for acute myelogenous leukemia using 4-hydroperoxycyclophosphamide and VP-16 purged bone marrow

S. Gulati, L. Acaba, J. Yahalom, L. Reich, R. Motzer, J. Crown, M. Doherty, B. Clarkson, E. Berman, J. Atzpodien, M. Andreeff, T. Gee

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32 Scopus citations

Abstract

Thirty adult patients with acute myelogenous leukemia (AML) in remission were treated with hyperfractionated total body irradiation, VP-16, and cyclophosphamide followed by infusion of autologous bone marrow purged with 4-hydroperoxycyclophosphamide and VP-16. Fifteen patients were transplanted in first remission (R1), 13 in second remission (R2), and two in third remission (R3). All patients had hematopoietic engraftment. The median time to achieve a white blood cell count of 1.0 x 109/l and a neutrophil count of 500 x 106/l was 32 days. The median time to achieve an unsupported platelet count of 50 x 109/l was 70 days. There were four transplant-related deaths, all in patients in R2. Ten patients have relapsed, including both patients transplanted in R3. The disease-free survival (DFS) of all patients is 52%, median follow-up not yet reached. Although the number of patients in each group is small and follow-up is limited, there is a trend toward improved actuarial DFS in patients transplanted in R1 compared with patients transplanted in R2 (72 vs 39%; p = 0.081). Use of VP-16 in the conditioning regimen as well as in the purging procedure is feasible in the treatment of patients with AML.

Original languageEnglish
Pages (from-to)129-134
Number of pages6
JournalBone Marrow Transplantation
Volume10
Issue number2
StatePublished - 1992
Externally publishedYes

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