Long-term follow-up of 14 patients with philadelphia chromosome-positive acute lymphoblastic leukemia following autologous bone marrow transplantation in first complete remission.
We describe the clinical outcome of autologous bone marrow transplantation (ABMT) for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL). Between 1985 and 2000, 14 patients in first complete remission underwent transplantation. In all cases, harvested marrow was purged with a cocktail of complement and monoclonal antibodies to common acute lymphoblastic leukemia antigen (CALLA). Eight patients died following BMT: 2 patients from interstitial pneumonia and 6 from disease recurrence. For the 6 surviving patients in continuous remission, the median follow-up period was 96 months. The probability of disease-free survival and the rate of relapse at 5 years were 41.7% and 51.4%, respectively. Minimal residual disease (MRD) was assayed quantitatively with patient-specific D-JH probes in 6 of 14 cases. A higher residual tumor burden at marrow harvest was associated with subsequent relapse. Efforts to reduce the MRD burden before harvesting stem cells should improve the clinical outcome of ABMT.
Mizuta
Shuichi
S
Department of Hematology, Fujita Health University Hospital, Toyoake, Japan.
Kohno
Akio
A
Morishita
Yoshihisa
Y
Atsuta
Yoshiko
Y
Sao
Hiroshi
H
Miyamura
Koichi
K
Sakamaki
Hisashi
H
Ueda
Ryuzo
R
Morishima
Yasuo
Y
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D014182:Transplantation, Autologous