Autologous Peripheral Blood Stem Cell Transplantation for Adults with B-Lineage Acute Lymphoblastic Leukemia: A Pilot Study

Abstract

We conducted a pilot study on autologous peripheral blood stem cell transplantation (PBSCT) for 11 adults with B-lineage acute lymphoblastic leukemia (ALL) in first complete remission (CR) or even in those with more advanced stages. All patients achieved CR by induction therapy, of whom 10 were treated with anthracycline, vincristine and prednisolone-based regimens. After consolidation therapy, all patients except one received high-dose cytarabine followed by granulocyte colony-stimulating factor (G-CSF) administration to collect PBSCs. Ten patients received busulfan 4 mg/kg for 4 days, etoposide 20 mg/kg for 3 days and ranimustine 200 mg/m2 for 2 days as a conditioning regimen. One received a regimen consisting of etoposide, cyclophosphamide and total body irradiation. From day 1, G-CSF was given intravenously, and no additional chemotherapy was administered. At the median follow-up time of 30.8 months, four of six patients with standard-risk B-lineage ALL survived within the range of 19.7 to 85.4 months without relapse. In contrast, only one of five with high-risk B-lineage ALL survived for 36.3 months without relapse. Autologous PBSCT as post-remission therapy may prolong CR in adults with standard-risk B-lineage ALL.

The role of diagnosis in patients failing peripheral blood progenitor cell mobilization

“…For adults with ALL there are fewer data on the ability to induce PBPC mobilization 34,35 . Atta and colleagues 34 reported mobilization failure in 6 of 20 patients with BCR‐ABL positive ALL, a lower percentage than in our group.…”

Adult acute lymphoblastic leukaemia

“…These procedures are known as allogeneic or autologous BM or blood-derived stem-cells transplants, respectively [332][333][334][335][336][337][338]. In the allogeneic setting, the antileukaemic effect is strictly associated with the occurrence of a graftversus-host (GVH) disease [339][340][341][342][343].…”