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Autologous bone marrow or peripheral blood stem cell transplantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center.
Bone Marrow Transplant. 1995 Aug; 16(2):241-7.BM

Abstract

The aim of this study was to evaluate the use of maintenance chemotherapy after autotransplantation in adult acute lymphoblastic leukemia (ALL), and to compare the relative durability of marrow and peripheral blood stem cell grafts to chemotherapy. Fifty consecutive ALL patients received 200 mg/m2 melphalan alone or 110 mg/m2 melphalan with total-body irradiation in first remission, followed by autologous marrow (ABMT, n = 38) or peripheral blood stem cells (PBSCT, n = 12). After hematologic recovery, 6-mercaptopurine and methotrexate were administered for 2 years. 6-mercaptopurine could be given to 78.9% of ABMT recipients at a median daily dose of 33.5 mg/m2, and to 91.7% of PBSCT recipients at a median daily dose of 44.1 mg/m2. ABMT recipients started 6-mercaptopurine at a median of 58.5 days post-transplant, and PBSCT recipients at 32 days (P = 0.002). 52.6% of ABMT recipients and 75% of PBSCT recipients received weekly methotrexate. No graft failure was seen as a result of chemotherapy. The actuarial 5-year probabilities of overall survival, survival in first remission and relapse were 56.2, 53.2, and 30.6%, respectively. We conclude that administration of maintenance chemotherapy after autografting in adult ALL may reduce relapse. A randomized study is required to evaluate the relative efficacy of PBSCT vs ABMT, and the role of post-transplant maintenance chemotherapy.

Authors+Show Affiliations

Leukaemia Unit, Royal Marsden Hospital, Sutton, Surrey, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7581142

Citation

Powles, R, et al. "Autologous Bone Marrow or Peripheral Blood Stem Cell Transplantation Followed By Maintenance Chemotherapy for Adult Acute Lymphoblastic Leukemia in First Remission: 50 Cases From a Single Center." Bone Marrow Transplantation, vol. 16, no. 2, 1995, pp. 241-7.
Powles R, Mehta J, Singhal S, et al. Autologous bone marrow or peripheral blood stem cell transplantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center. Bone Marrow Transplant. 1995;16(2):241-7.
Powles, R., Mehta, J., Singhal, S., Horton, C., Tait, D., Milan, S., Pollard, C., Lumley, H., Matthey, F., & Shirley, J. (1995). Autologous bone marrow or peripheral blood stem cell transplantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center. Bone Marrow Transplantation, 16(2), 241-7.
Powles R, et al. Autologous Bone Marrow or Peripheral Blood Stem Cell Transplantation Followed By Maintenance Chemotherapy for Adult Acute Lymphoblastic Leukemia in First Remission: 50 Cases From a Single Center. Bone Marrow Transplant. 1995;16(2):241-7. PubMed PMID: 7581142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Autologous bone marrow or peripheral blood stem cell transplantation followed by maintenance chemotherapy for adult acute lymphoblastic leukemia in first remission: 50 cases from a single center. A1 - Powles,R, AU - Mehta,J, AU - Singhal,S, AU - Horton,C, AU - Tait,D, AU - Milan,S, AU - Pollard,C, AU - Lumley,H, AU - Matthey,F, AU - Shirley,J, PY - 1995/8/1/pubmed PY - 1995/8/1/medline PY - 1995/8/1/entrez SP - 241 EP - 7 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 16 IS - 2 N2 - The aim of this study was to evaluate the use of maintenance chemotherapy after autotransplantation in adult acute lymphoblastic leukemia (ALL), and to compare the relative durability of marrow and peripheral blood stem cell grafts to chemotherapy. Fifty consecutive ALL patients received 200 mg/m2 melphalan alone or 110 mg/m2 melphalan with total-body irradiation in first remission, followed by autologous marrow (ABMT, n = 38) or peripheral blood stem cells (PBSCT, n = 12). After hematologic recovery, 6-mercaptopurine and methotrexate were administered for 2 years. 6-mercaptopurine could be given to 78.9% of ABMT recipients at a median daily dose of 33.5 mg/m2, and to 91.7% of PBSCT recipients at a median daily dose of 44.1 mg/m2. ABMT recipients started 6-mercaptopurine at a median of 58.5 days post-transplant, and PBSCT recipients at 32 days (P = 0.002). 52.6% of ABMT recipients and 75% of PBSCT recipients received weekly methotrexate. No graft failure was seen as a result of chemotherapy. The actuarial 5-year probabilities of overall survival, survival in first remission and relapse were 56.2, 53.2, and 30.6%, respectively. We conclude that administration of maintenance chemotherapy after autografting in adult ALL may reduce relapse. A randomized study is required to evaluate the relative efficacy of PBSCT vs ABMT, and the role of post-transplant maintenance chemotherapy. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/7581142/Autologous_bone_marrow_or_peripheral_blood_stem_cell_transplantation_followed_by_maintenance_chemotherapy_for_adult_acute_lymphoblastic_leukemia_in_first_remission:_50_cases_from_a_single_center_ L2 - https://ClinicalTrials.gov/search/term=7581142 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -