[Autologous transplantation of recombinant interleukine-2 activated bone marrow for acute promyelocytic leukemia].
OBJECTIVE
To explore the benefit of autologous transplantation of interleukine-2 activated bone marrow (ABM) in acute promyelocytic leukemia (APL) as consolidation therapy.


METHODS
31 patients with APL, 27 in first complete remission (CR1), 3 in CR2, and 1 in partial remission (PR) after the second relapse, were treated with autologous transplantation of ABM. The conditioning regimens included MACC protocol (Melphalan, Ara-C, CTX, and CCNU) in 26 patients and TBI + CY protocol in 5 patients. The PML/RARa fusion gene was measured by fluorescence in situ hybridization. Kaplan-Meier survival analysis model was used to estimate the disease-free survival (DFS) rate at 5 years post-transplantation and COX regression model was used to analyze the DFS-influencing factors, including sex, PML/RARa positive state, pre-transplantation state (CR1, CR2, or PR), white blood cell (WBC) count, and platelet (PBC) count.


RESULTS
The 27 patients in CR1 had a DFS time of 3 to 113 months (with a mean DFS time of 46 months), and a 5-year DFS rate of 100%; none of them suffered a relapse after transplantation. One of the 3 patients in CR2 relapsed in 19 months after the transplantation and the other two patients had been in DFS state for 7 and 33 months respectively. The patient in PR obtained CR and relapsed 8 months after the transplantation. All the patients showed reconstitution of hematopoiesis. None of the patients died of transplantation-related complication. Multivariate analysis showed that long-term survival was correlated with the pre-transplantation statues and not with sex, positivity of PML/RARa, and WBC and PBC counts.


CONCLUSIONS
Autologous transplantation of ABM reduces the relapse and increases the long-term survival in the patients with APL in CR, especially in CR1.
Liu
Qi-fa
QF
Department of Hematology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
Sun
Jing
J
Zhang
Yu
Y
Liu
Xiao-li
XL
Xu
Bing
B
Xu
Dan
D
Feng
Ru
R
Meng
Fan-yi
FY
Song
Lan-lin
LL
Zhou
Shu-yun
SY
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D006801:Humans; D007376:Interleukin-2 / Q000494:pharmacology*; D015473:Leukemia, Promyelocytic, Acute; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011994:Recombinant Proteins / Q000494:pharmacology; D012008:Recurrence; D014182:Transplantation, Autologous
D007376:Interleukin-2; D009363:Neoplasm Proteins; D015514:Oncogene Proteins, Fusion; D011994:Recombinant Proteins; C093476:promyelocytic leukemia-retinoic acid receptor alpha fusion oncoprotein