title: Autologous PBSC transplant for late onset AML after mafosfamide-purged and TBI-containing autologous BMT.
abstract: The prognosis of AML patients who fail autologous BMT and lack a donor for a salvage allogeneic BMT is very poor. We administered an alternative drug treatment including autologous PBSC transplant to a child who relapsed with AML 4 years after a mafosfamide-purged and TBI-containing BMT for second remission AML. Treatment comprised induction-consolidation with 'short' ICE courses (idarubicin-Ara C-etoposide for 2 days), high-dose CY plus G-CSF with collection of CD34+ PBSC and myeloablative treatment with high-dose mitoxantrone/BEAM supported by autologous PBSC reinfusion. The outcome was complete response, lasting 24 months. The patient died in remission of drug-related cardiotoxicity. This report emphasizes the possibility of a secondary AML after mafosfamide-purge autologous BMT, and documents the feasibility of an autologous PBSC transplant in such a high risk setting.
authors.affiliation: Divisione di Ematologia, Ospedali Riuniti, Bergamo, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Bassan
authors.forename: S
authors.initials: S
authors.lastname: Cortelazzo
authors.forename: A
authors.initials: A
authors.lastname: Rambaldi
authors.forename: P
authors.initials: P
authors.lastname: Cornelli
authors.forename: G
authors.initials: G
authors.lastname: Borleri
authors.forename: P
authors.initials: P
authors.lastname: Bellavita
authors.forename: A
authors.initials: A
authors.lastname: Biondi
authors.forename: T
authors.initials: T
authors.lastname: Barbui
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000031:analogs & derivatives*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D014182:Transplantation, Autologous; D014916:Whole-Body Irradiation
chemical_list: C048341:mafosfamide; D003520:Cyclophosphamide