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Allogeneic matched T-cell-depleted bone marrow transplantation for acute leukemia patients.
Cancer J Sci Am. 1996 Nov-Dec; 2(6):330-4.CJ

Abstract

PURPOSE

We evaluated the efficacy and toxicity of a conditioning regimen designed to overcome the increased risk of rejection and relapse associated with T-cell-depleted bone marrow transplants.

PATIENTS AND METHODS

Fifty-four patients with acute leukemia received an allogeneic T-depleted bone marrow transplant from an HLA-matched (n=52) or one locus mismatched (n=2) sibling donor between June 1989 and November 1993. Nineteen acute myeloid leukemia patients and 17 acute lymphoid leukemia patients were in complete remission, and 11 acute myeloid leukemia patients and 7 acute lymphoid leukemia patients were in relapse. Patients were preconditioned with hyperfractionated total body irradiation of 1.2 Gy three times a day on days -9 to -6 (total 14.4 Gy), 10 mg/kg thiotepa on day -5, 4 mg/kg rabbit antithymocyte globulin on days -4 to -1, and 50 mg/kg cyclophosphamide on days -3 and -2.

RESULTS

All patients were fully engrafted at a median of 15 days after transplant. No patient rejected the transplant or developed acute or chronic graft-versus-host disease. Of 19 patients with acute myeloid leukemia in complete remission, 14 survive. Four of the 11 patients with acute myeloid leukemia in relapse survive. Twelve acute myeloid leukemia patients died (three of relapse, eight of toxicity, one of other causes). Eleven of 24 patients with acute lymphoid leukemia (one treated in relapse) are alive in complete remission; the other 13 died (nine of relapse, four of toxicity). Interstitial pneumonia, the main cause of toxic death, occurred in 9.26% of total patients. The median follow-up time at this writing is 30 months.

CONCLUSIONS

The absence of rejection and graft-versus-host disease and the relatively low relapse and toxicity rates are evidence for the efficacy of our conditioning regimen.

Authors+Show Affiliations

Institute of Radiotherapy Oncology, General Hospital and Perugia University, Perugia, Italy.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 availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9166553

Citation

Aristei, C, et al. "Allogeneic Matched T-cell-depleted Bone Marrow Transplantation for Acute Leukemia Patients." The Cancer Journal From Scientific American, vol. 2, no. 6, 1996, pp. 330-4.
Aristei C, Aversa F, Raymondi C, et al. Allogeneic matched T-cell-depleted bone marrow transplantation for acute leukemia patients. Cancer J Sci Am. 1996;2(6):330-4.
Aristei, C., Aversa, F., Raymondi, C., Marsella, A. R., Panizza, B. M., Perrucci, E., Piro, F., Maranzano, E., Lupattelli, M., Martelli, M. F., & Latini, P. (1996). Allogeneic matched T-cell-depleted bone marrow transplantation for acute leukemia patients. The Cancer Journal From Scientific American, 2(6), 330-4.
Aristei C, et al. Allogeneic Matched T-cell-depleted Bone Marrow Transplantation for Acute Leukemia Patients. Cancer J Sci Am. 1996 Nov-Dec;2(6):330-4. PubMed PMID: 9166553.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Allogeneic matched T-cell-depleted bone marrow transplantation for acute leukemia patients. AU - Aristei,C, AU - Aversa,F, AU - Raymondi,C, AU - Marsella,A R, AU - Panizza,B M, AU - Perrucci,E, AU - Piro,F, AU - Maranzano,E, AU - Lupattelli,M, AU - Martelli,M F, AU - Latini,P, PY - 1996/11/1/pubmed PY - 2006/10/25/medline PY - 1996/11/1/entrez SP - 330 EP - 4 JF - The cancer journal from Scientific American JO - Cancer J Sci Am VL - 2 IS - 6 N2 - PURPOSE: We evaluated the efficacy and toxicity of a conditioning regimen designed to overcome the increased risk of rejection and relapse associated with T-cell-depleted bone marrow transplants. PATIENTS AND METHODS: Fifty-four patients with acute leukemia received an allogeneic T-depleted bone marrow transplant from an HLA-matched (n=52) or one locus mismatched (n=2) sibling donor between June 1989 and November 1993. Nineteen acute myeloid leukemia patients and 17 acute lymphoid leukemia patients were in complete remission, and 11 acute myeloid leukemia patients and 7 acute lymphoid leukemia patients were in relapse. Patients were preconditioned with hyperfractionated total body irradiation of 1.2 Gy three times a day on days -9 to -6 (total 14.4 Gy), 10 mg/kg thiotepa on day -5, 4 mg/kg rabbit antithymocyte globulin on days -4 to -1, and 50 mg/kg cyclophosphamide on days -3 and -2. RESULTS: All patients were fully engrafted at a median of 15 days after transplant. No patient rejected the transplant or developed acute or chronic graft-versus-host disease. Of 19 patients with acute myeloid leukemia in complete remission, 14 survive. Four of the 11 patients with acute myeloid leukemia in relapse survive. Twelve acute myeloid leukemia patients died (three of relapse, eight of toxicity, one of other causes). Eleven of 24 patients with acute lymphoid leukemia (one treated in relapse) are alive in complete remission; the other 13 died (nine of relapse, four of toxicity). Interstitial pneumonia, the main cause of toxic death, occurred in 9.26% of total patients. The median follow-up time at this writing is 30 months. CONCLUSIONS: The absence of rejection and graft-versus-host disease and the relatively low relapse and toxicity rates are evidence for the efficacy of our conditioning regimen. SN - 1081-4442 UR - https://www.unboundmedicine.com/medline/citation/9166553/Allogeneic_matched_T_cell_depleted_bone_marrow_transplantation_for_acute_leukemia_patients_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -