Autologous marrow transplantation for patients with acute myeloid leukemia in untreated first relapse or in second complete remission.

Fb, Petersen; Lynch, Marie‐Josée; Clift, R A; Appelbaum, FR; Sanders, Jean E.; Bensinger, WI; Benyunes, Mark C.; Doney, Kristine; Fefer, A; Martin, Patrick

doi:10.1200/jco.1993.11.7.1353

Cited by 51 publications

(25 citation statements)

References 14 publications

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“…Overall, the relapse probability, 66%, is similar to that reported There was a 6% mortality rate on this study, 3.5% at the MTD, due to infections and/or pulmonary toxicity. While without IL-2 4 and higher than that reported in our previous study with IL-2. 11,33 However, the regimen and source of all non-relapse causes of morbidity and mortality during or shortly after the IL-2 treatment are ascribed to IL-2, some IL-2 used in this trial was different from that used in the past (Roche in the past, Chiron in the present trial), as was may have been due to the transplant conditioning regimens and/or pre-existing medical conditions.…”

Section: Discussioncontrasting

confidence: 68%

“…[1][2][3][4] Intensification of transplant conditioning regimens has not substantially reduced the problem. 18 It is hypothesized that IL-2 administered early after transplantation might eradicate residual tumor cells, thereby reducing the relapse rate.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] In non-transplant settings, IL-2 gible to begin IL-2 therapy as soon as the following criteria has been reported to induce clinical responses in patients were met: trilineage engraftment by bone marrow examinwith acute myelogenous leukemia (AML), 5,6 lymphoma, 7,8 ation; neutrophil count у500/mm 3 ; platelet count and multiple myeloma (MM) 9 refractory to conventional у20 000/mm 3 with р1 transfusion per day; creatinine Ͻ2.0 mg/dl; bilirubin Ͻ3.0 mg/dl; no active infection off antibiotics; Ͼ7 days off treatment with corticosteroids, pentoxi-…”

Section: The Success Of Autologous Stem Cell Transplantation (Asct) Fmentioning

confidence: 99%

See 2 more Smart Citations

Interleukin-2 after autologous stem cell transplantation for hematologic malignancy: a phase I/II study

Robinson

Benyunes

Thompson

et al. 1997

Bone Marrow Transplant

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Summary:therapy. It is postulated that immunotherapy with interleukin-2 (IL-2), administered early after ASCT, at a time of minimal residual disease, may reduce the relapse rate. The success of autologous stem cell transplantation (ASCT) for hematologic malignancy is limited largelyAn earlier phase I trial with IL-2 (Hoffman LaRoche, Nutley, NJ, USA) administered early after ABMT for hemby a high relapse rate. It is postulated that IL-2 administered after ASCT may eliminate minimal residual disatologic malignancies identified a tolerable regimen which induced immunomodulatory effects. 10 The encouraging ease and thereby reduce relapses. A phase I/II study was performed to identify a regimen of IL-2 (Chiron) that clinical results observed in the course of that phase I trial 11,12 stimulated the design of phase III trials. However, could be given early after ASCT in phase III trials. In the phase I study, beginning a median of 46 days after since Roche IL-2 became unavailable, the current phase I/II trial was performed to identify an equitoxic regimen of IL-ASCT for hematologic malignancy, cohorts of three to four patients received escalating doses of 'induction' IL-2 provided by Chiron which could then be used in randomized trials to determine whether post-transplant IL-2 2 of 9, 10, or 12 × 10 6 IU/m 2 /day for 4 or 5 days by continuous i.v. infusion (CIV), followed by a 4-day rest therapy will reduce relapses in patients with AML and NHL. period, and then 1.6 × 10 6 IU/m 2 /day of maintenance IL-2 by CIV for 10 days. The maximum tolerated dose (MTD) of induction IL-2 was 9 × 10 6 IU/m 2 /day × 4. In the phase II study, 52 patients received the MTD. Eighty Materials and methods percent of patients completed induction IL-2. Most patients exhibited some degree of capillary leak. OnePatient characteristics patient died of CMV pneumonia and one died of ARDS.Between November 1992 and April 1995, 67 patients with Maintenance IL-2 was well tolerated. In the phase I/II a median age of 44 (range 1-63) were treated with highstudy, 16 of 31 patients with non-Hodgkin lymphoma dose chemotherapy, with or without fractionated total body (NHL), 3/8 with Hodgkin disease (HD), 4/17 with AML, irradiation, plus an infusion of autologous stem cells from and 4/5 with ALL remain in CR. Two of six multiple peripheral blood (PB; n = 34), bone marrow (BM; n = 23), myeloma (MM) patients remain in PR. Although the or BM and PB (n = 10) followed by IL-2 therapy. Patients regimen of IL-2 identified had significant side-effects in were treated at the University of Washington Medical some patients, it was well tolerated in the majority of Center, the Fred Hutchinson Cancer Research Center patients. Phase III prospectively randomized clinical (FHCRC) or the Seattle Veteran's Administration Medical trials are in progress to determine if this IL-2 regimen Center. Patients were treated for NHL (31), AML (17), will decrease the relapse rate after ASCT for AML Hodgkin's disease (HD; eight), MM (six), or acute lymand NHL.phoblastic leukemia (ALL; fou...

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: The Success Of Autologous Stem Cell Transplantation (Asct) Fmentioning

confidence: 99%

See 1 more Smart Citation

Interleukin-2 after autologous stem cell transplantation for hematologic malignancy: a phase I/II study

Robinson

Benyunes

Thompson

et al. 1997

Bone Marrow Transplant

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“…In general, RRT would be less in patients receiving autografts because of the lack of graft-versushost reaction, implying the possibility that autograft patients could tolerate higher doses in their conditioning regimen and avoid some relapses. Petersen et al investigated the tolerable dose of both BU and CY in combination with total body irradiation (TBI) for patients receiving autografts and HLA-identical allografts [20]. According to their pilot study, a 20% larger dose of BU and CY could be safely escalated in patients with autografts.…”

Section: Discussionmentioning

confidence: 99%

Conditioning with targeted busulfan for autologous peripheral blood stem cells transplantation for acute myelogenous leukemia in an XYY male

et al. 2004

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We report herein a 19-year-old Japanese male with XYY syndrome who developed acute myelogenous leukemia. During three courses of cytotoxic chemotherapy, he suffered repeated hepatic and renal insufficiencies, possibly related to latent dysfunction from the XYY syndrome. The patient was treated with granulocyte colony-stimulating factor combined with etoposide, cytarabine, and busulfan (the latter adjusted to a targeting dose) followed by autologous peripheral blood stem cell transplantation. He had no severe regimen-related toxicities and is now free of leukemia. Am.

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“…The mobilizing tumors. 4,5 Other indications are the subject of intensive chemotherapy regimens were high-dose cyclophosphamide investigation. The majority of these procedures are, for hisor etoposide, or various combinations of standard dose torical and insurance reasons, performed in university or cytotoxics.…”

Section: High-dose Therapy With Bone Marrow (Bm) or Blood Stem Cell (mentioning

confidence: 99%

High-dose chemotherapy with autologous stem cell transplantation is feasible and safe in a regional hospital. A 6-year experience in southern Switzerland

Regazzoni

Marini

Grob

et al. 1997

Bone Marrow Transplant

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Summary:cations for high-dose therapy are increasing, its execution will probably need to be more and more extended to smaller hospitals. High-dose therapy with bone marrow (BM) or blood stem cell (BSC) support is a high-technology techniqueThis report intends to demonstrate that myeloablative treatments can be performed in a district hospital when all usually administered in specialized tertiary centers. The use of BSC has made this technique simpler and accessthe necessary structures are provided and the staff have been sufficiently trained. We relate the experience of the ible also to smaller hospitals. We retrospectively analyzed the data of patients with lymphoma, leukemia and 'Servizio Oncologico Ticinese', an oncology department in southern Switzerland not directly affiliated with a univerother tumors who received high-dose therapy and BM or BSC transplantation in our district hospital, looking sity. The department consists of a 17-bed in-patient ward closely cooperating with five out-patient facilities distribat the type of procedure performed, complications, use of growth factors, and progression-free and overall suruted in the county hospitals of the surrounding area. This paper reports the results with high-dose regimens and stem vival. A total of 40 patients were transplanted over 6 years. No procedure-related deaths and no permanent cell rescue in 40 patients treated during the first 6 years of this experience. organ toxicities were seen. The use of BSC brought about a great reduction in the duration of hospital stay, septic complications and transfusion of blood components. For patients with lymphoma (n = 20) the probPatients and methods abilities of progression-free survival and of overall survival at 2 years are 48% (95% C.I. 28-68%) and 68%Our transplant program was always directed by hematooncologists having spent at least 6 months in a bone mar-(95% C.I. 46-84%), respectively. Based on these data, we believe that ABMT and BSC transplantation are row transplantation center. They in turn instructed nurses, technicians and junior physicians in the management of feasible and safe in a peripheral hospital when the appropriate human and technical conditions are patients with aplasia, and in the collection and processing of the stem cells. present. Treatment outcome is then comparable to that of specialized centers.Bone marrow was collected under general anesthesia by the standard technique, and for two patients with acute leuKeywords: high-dose therapy; stem cell transplantation; peripheral hospital; lymphoma kemia it was purged in vitro with monoclonal antibodies and complement. Blood stem cells were collected with an intermittent flow cell separator (V50 or MCS3p; Haemonetics, Switzerland) after mobilization with growth factors High-dose chemotherapy with autologous stem cell rescue alone (four patients), chemotherapy alone (two patients) or is now a favorite treatment for both relapsed Hodgkin's and in most cases with a combination of chemotherapy and non-Hodgkin's lymphomas, 1-3 and is currently...

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Autologous marrow transplantation for patients with acute myeloid leukemia in untreated first relapse or in second complete remission.

Cited by 51 publications

References 14 publications

Interleukin-2 after autologous stem cell transplantation for hematologic malignancy: a phase I/II study

Interleukin-2 after autologous stem cell transplantation for hematologic malignancy: a phase I/II study

Conditioning with targeted busulfan for autologous peripheral blood stem cells transplantation for acute myelogenous leukemia in an XYY male

High-dose chemotherapy with autologous stem cell transplantation is feasible and safe in a regional hospital. A 6-year experience in southern Switzerland

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