title: Autologous purified peripheral blood SCT in childhood low-risk relapsed ALL.
abstract: The treatment of childhood B-cell-precursor ALL after isolated-extramedullary or late relapse is controversial. Most approaches are based on chemotherapy or allogeneic transplantation. The aim of this report is to assess the long-term outcome of children with 'low-risk' relapsed ALL treated according to a prospective purified auto-transplantation protocol. From January 1997 to March 2004, at a single pediatric Center, 30 ALL consecutive children, lacking an HLA-identical sibling, were treated according to the autologous purified peripheral blood stem cell protocol after isolated-extramedullary (7) or late medullary (24) relapse. After the 'DIAVE' mobilizing regimen a median of 11.6 × 10(6)CD34+/Kg (range 3.9-27.4) were collected. Leukaphereses were depleted by 99% of CD19+cells (range 98-100) by means of a double step immunological purification. The conditioning regimen included TBI. No early severe complications nor transplant-related deaths occurred; late effects, as expected, mostly consisted in endocrinological issues and were assessed at a median follow-up of 8.5 years. Five-year-EFS and survival were 68.5% (s.e. 7.9) and 85.7% (s.e. 5.9), respectively, for the 35 eligible patients and 70.0% (s.e. 8.4) and 86.7% (s.e. 6.2) for the 30 patients actually transplanted as per protocol. The outcome of this series favorably compares with historical data regarding both autologous transplantation and standard salvage chemotherapy.
authors.affiliation: Clinica Pediatrica, Università degli Studi di Milano Bicocca, Monza, Italy. a.balduzzi@hsgerardo.org
authors.forename: A
authors.initials: A
authors.lastname: Balduzzi
authors.forename: S
authors.initials: S
authors.lastname: Bonanomi
authors.forename: M G
authors.initials: MG
authors.lastname: Valsecchi
authors.forename: G
authors.initials: G
authors.lastname: Gaipa
authors.forename: P
authors.initials: P
authors.lastname: Perseghin
authors.forename: S
authors.initials: S
authors.lastname: Songia
authors.forename: O
authors.initials: O
authors.lastname: Maglia
authors.forename: V
authors.initials: V
authors.lastname: Rossi
authors.forename: S
authors.initials: S
authors.lastname: Motta
authors.forename: L
authors.initials: L
authors.lastname: Di Maio
authors.forename: M
authors.initials: M
authors.lastname: Dassi
authors.forename: C
authors.initials: C
authors.lastname: Uderzo
authors.forename: V
authors.initials: V
authors.lastname: Conter
authors.forename: G
authors.initials: G
authors.lastname: Henze
authors.forename: A
authors.initials: A
authors.lastname: von Stackelberg
authors.forename: A
authors.initials: A
authors.lastname: Rovelli
authors.forename: A
authors.initials: A
authors.lastname: Biondi
authors.forename: S
authors.initials: S
authors.lastname: Galimberti
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D018365:Neoplasm, Residual / Q000175:diagnosis; D036102:Peripheral Blood Stem Cell Transplantation / Q000401:mortality; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery*; D012008:Recurrence; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous