Bone marrow purging with mafosfamide ? A critical survey

Abstract

Autologous bone marrow transplantation (ABMT) is increasingly used to consolidate remissions, primarily in hematological disease. Various purging strategies have been developed to minimize the risk of reimplantation of tumor cells with the bone marrow autotransplant. Pharmacological purging with the oxazaphosphorine derivative mafosfamide has been studied extensively, and recent clinical data suggest that purging with mafosfamide may translate into superior remission duration if compared to nonpurged ABMT in acute leukemia. Chemical and experimental data relevant to mafosfamide-purging and clinical results are reviewed, with special emphasis on safety aspects.

Bone Marrow Transplantation

“…Ex vivo marrow purging with the activated-oxazolphosphorine derivatives 4-hydroxyperoxycyclophosphamide (4HC) and INN mafosfamide (Asta-Z 7557) has been used most extensively after the pioneering Baltimore studies [466]. Mafosfamide is generally considered to be the best agent, and has been analysed in depth [467], also with reference to its differential effects upon normal and leukaemic stem cells [468]. The in-vitro chemosensitivity of leukaemic progenitor cells (AML-CFU) to a combination of mafosfamide lysine (Asta-Z 7654) and etoposide was studied, and it was found that the chemosensitivity of AML-CFU closely mimicked that of normal CFU-GM [469].…”

The Selective Uptake of Benzoporphyrin Derivative Mono‐Acid Ring A Results in Differential Cell Kill of Multiple Myeloma Cells in vitro

“…Some of the present purging modalities under study include the application of pharmacologic agents, e.g. 4-hydroperoxycyclophosphamide, vincristine and mafosfamide (5,8,9). Unfortunately, nonspecific cytotoxicity is a problem with this method.…”