Double autologous bone marrow transplantation for acute myelogenous leukemia in a patient treated for Hodgkin's disease

Abstract

A 30-year-old man developed acute myelogenous leukemia nearly 3 years after treatment of Hodgkin's disease with radiation and three chemotherapy combinations. Remission was induced with one cycle of high-dose Ara-C therapy. Three cycles of consolidation chemotherapy were given. The patient then had two autologous bone marrow transplants, the first after conditioning with 5 Gy total body irradiation, the second after Melphalan 140 mg/m2. The procedures were well tolerated, although hematological reconstitution was very slow after the second autotransplant. The patient has been disease-free for over 4 years. Such patients may be more vulnerable to transplant-related complications because of their previous exposure to chemotherapy and radiation, which may damage several organs including the bone marrow. This report demonstrates that patients with secondary acute myelogenous leukemia may tolerate a double autotransplant procedure and achieve durable remissions.

Prompt engraftment using autologous peripheral blood stem cells for double autologous bone marrow rescue

“…With this MNC dose, engraftment was prompt and sustained, and his tumor burden was reduced by >50%. Because CFUs following recovery from BMR are reported to be reduced in number and potency [7], a two fold increase in MNC dose (>14 X lo8 MNC/kg) was used for BMR 2. However, the CFU-GM/MNC concentration in this patient was unchanged despite a markedly hypocellular bone marrow.…”