High-dose chemotherapy and unpurged autologous bone marrow transplantation for acute leukemia in second or subsequent remission.
The authors administered high-dose chemotherapy with cyclophosphamide, BCNU (carmustine) and VP-16 (etoposide) plus autologous bone marrow transplantation (ABMT) to 22 adult patients with relapsed acute leukemia in second or subsequent remission. The marrow was not treated ex vivo. The long-term, disease-free survival rate was 14%. Comparison of results with other treatments can be difficult because of patient selection biases. The concept of inversion (achievement of a longer remission with salvage therapy than with prior treatments) is proposed to compare treatment results. Three patients remain in complete remission beyond 4 years, with inversions. More intensive cytoreductive regimens will be needed to improve results.
Spinolo
J A
JA
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Dicke
K A
KA
Horwitz
L J
LJ
Jagannath
S
S
McCredie
K
K
Estey
E
E
Kantarjian
H
H
Zander
A R
AR
Keating
M
M
Spitzer
G
G
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002330:Carmustine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006098:Granulocytes; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000401:mortality / Q000628:therapy*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000401:mortality / Q000628:therapy*; D012074:Remission Induction; D015996:Survival Rate
D005047:Etoposide; D003520:Cyclophosphamide; D002330:Carmustine