Autologous peripheral blood progenitor cell transplantation mobilized with high-dose cytarabine in acute myeloid leukemia in first complete remission

Pavlovsky, Santiago; Fernández, Isolda; Milone, Gustavo; Rolón, Juliana Martínez; Corrado, Claudia; Desmery, Pablo; Dignani, Cecilia; Michelet, Marine; Juni, Mariana

doi:10.1023/a:1008271624978

Cited by 9 publications

(3 citation statements)

References 14 publications

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“…Because in vivo purging with HD Ara-C has been used in several trials (Zittoun et al, 1995;Harousseau et al, 1997;Schiller et al, 1997;Burnett et al, 1998;Pavlovsky et al, 1998) and has a major disadvantage in prolonging the delay to platelet recovery, its use before ABMT should be avoided. Presently, the choice between conventional chemotherapy and BMT is being approached in a different way, according to the prognostic factors at diagnosis, such as cytogenetics (Ferrant et al, 1997;Bloomfield et al, 1998;Grimwade et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

No impact of high‐dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission

et al. 2000

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High‐dose cytarabine is currently used in combination with anthracycline in the treatment of acute myeloblastic leukaemia (AML). Moreover, high‐dose cytarabine has been reported to produce long‐term disease‐free survival in a proportion of patients, especially in certain subtypes of AML. However, it remains unknown whether the outcome of patients undergoing allogeneic or autologous stem cell transplantation is influenced by previous treatment with high‐dose cytarabine. To this end, 1672 patients with AML in first remission who were reported to the Acute Leukaemia Working Party registry of the European Group for Blood and Marrow Transplantation (EBMT) and who were transplanted between 1980 and 1995 were analysed according to the dose intensity of cytarabine given at induction and/or consolidation. Autologous stem cell transplantation (ABMT) was performed in 846 patients and allogeneic bone marrow transplantation (BMT) in 826 patients. This study shows that the dose of cytarabine (Ara‐C) given at induction and/or consolidation did not influence the relapse incidence in patients subsequently allografted or autografted. In addition, it did not give any advantage in terms of overall outcome. Therefore, high‐dose (HD) Ara‐C may not be needed for patients who have a planned stem cell transplantation (SCT) as post‐remission therapy. Nevertheless, HD Ara‐C may be utilized in certain subtypes of AML that are believed to be curable by chemotherapy alone.

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Section: Discussionmentioning

confidence: 99%

No impact of high‐dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission

et al. 2000

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“…Stem cell mobilization in AML patients by combining HIDAC and G-CSF has been investigated in two recent studies. Pavlovsky et al (23) reported successful stem cell mobilization by using HIDAC (six doses during 3 days) 1 G-CSF, and Shimazaki et al (24) reported that HIDAC (four doses during 2 days) 1 etoposide 1 G-CSF could be used for stem cell mobilization. Although both studies included relatively few patients, the results suggest that HIDAC 1 G-CSF can be used for stem cell mobilization in AML patients.…”

Section: Peripheral Blood Mobilized Stem Cell Transplantati Onmentioning

confidence: 99%

Autologous Stem Cell Transplantation As Post-Remission Therapy in Adult Acute Myelogenous Leukemia: Does Platelet Contamination of Peripheral Blood Mobilized Stem Cell Grafts Influence the Risk of Leukemia Relapse?

Bruserud

Foss

Abrahamsen

et al. 2000

Journal of Hematotherapy & Stem Cell Research

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Conventional chemotherapy of acute myelogenous leukemia (AML) results in an overall long-term disease-free survival of less than 50%, but for selected subsets of younger patients the prognosis can be improved by allogeneic stem cell transplantation. The use of autologous stem cell transplantation is now investigated as an alternative to allotransplantation due to its lower risk of serious complications. However, autotransplantation is associated with a relatively high risk of post-transplant AML relapse that can be derived from contaminating leukemia cells in the autograft. Peripheral blood mobilized stem cell (PBSC) grafts usually contain a higher number of platelets. The degree of platelet contamination is determined by the peripheral blood platelet count at the time of harvesting, and the platelets become activated and release soluble mediators during the ex vivo handling of PBSC grafts. Many of these platelet-derived mediators can bind to specific receptors expressed by AML blasts, and the platelet contamination may then alter AML blast survival and thereby influence the risk of post-transplant leukemia relapse. Therefore, we conclude that the platelet contamination of autologous stem cell grafts is possibly of clinical importance, but the effect of this nonstandardized parameter is difficult to predict in individual patients because the number of graft-contaminating platelets, the degree of platelet activation, and the effects of platelet-derived mediators on AML blasts differ between patients.

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“…High-dose cytarabine during induction or intensification improves the duration of complete remission (CR) and increases disease-free survival (DFS), especially in younger patients. Pavlovsky et al report results of in vivo purging of autologous PBSCs using high-dose cytarabine prior to the harvest in AML in first CR, resulting in a 30-month DFS of 62% [7]. In December 2015, we started a MAG regimen for leukemia and lymphoma patients in first CR employing high-dose cytarabine combined with mitoxantrone, followed by G-CSF/GM-CSF for consolidation and mobilization before peripheral blood autograft.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Study Comparing the Effects of G-CSF and G-CSF/GM-CSF for the Mobilization of Peripheral Blood Stem Cells by Mitoxantrone and High-Dose Cytarabine Chemotherapy

Dai¹,

Li²,

Li³

et al. 2021

COCB

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We investigated the efficiency of mitoxantrone (MIT) and high-dose cytarabine (Ara-C) chemotherapy followed by G-CSF and G-CSF/GM-CSF treatments for the mobilization of peripheral blood stem cells (PBSCs) in patients with leukemia and lymphoma. MIT was intravenously injected at 10 mg/(m2·d) for 2 to 3 days, followed by Ara-C injected intravenously at 2 g/m2 every 12 hours for 1 to 2 days. When white blood cell count recovered from the lowest value, 5 to 7.5 μg/ (kg·d) G-CSF was administered in 23 patients for 5 to 7 successive days. Another 27 patients received 3-5 μg/ (kg·d) G-CSF and 3-5μg/ (kg·d) GM-CSF. Autologous peripheral blood mononuclear cells were collected. Levels of CFU-GM and CD34+ cells were determined after unfreezing. The CD34+ cells and CFU-GM yields of 27 patients in G-CSF plus GM-CSF combination group [(8.79±3.11)×106/kg, (3.52±1.34)×105/kg, respectively] were significantly higher than those of patients receiving G-CSF alone (n=23) [(6.14±2.06)×106/kg, (2.03±1.06)×105/kg, respectively (P < 0.05)]. No obvious changes of T lymphocyte subsets in patients were observed when using G-CSF/GM-CSF, but levels of CD34+ cells increased gradually (P>0.05). The end-point separation blood volume was all above trebling TBV. No severe complications were observed during the mobilization and collection. Autologous PBSCT obtained quick hematopoietic reconstitution. In conclusion, MA chemotherapy combined with G-CSF alone and G-CSF/GM-CSF can safely and effectively mobilize autologous PBSCs, while G-CSF plus GM-CSF is superior to G-CSF alone. Large volume leukapheresis is an important method to enhance the production rate of stem cells and decrease harvesting time.

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Autologous peripheral blood progenitor cell transplantation mobilized with high-dose cytarabine in acute myeloid leukemia in first complete remission

Abstract: The above treatment results in a similar DFS rate as does rescue with bone marrow cells, with faster neutrophil and platelet recovery.

Cited by 9 publications

References 14 publications

No impact of high‐dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission

No impact of high‐dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission

Autologous Stem Cell Transplantation As Post-Remission Therapy in Adult Acute Myelogenous Leukemia: Does Platelet Contamination of Peripheral Blood Mobilized Stem Cell Grafts Influence the Risk of Leukemia Relapse?

A Randomized Study Comparing the Effects of G-CSF and G-CSF/GM-CSF for the Mobilization of Peripheral Blood Stem Cells by Mitoxantrone and High-Dose Cytarabine Chemotherapy

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