Repeated high-dose-melphalan with autologous bone marrow transplantation in acute non lymphocytic leukemia

1985 ◽  
Vol 28 (5) ◽  
pp. 477-488 ◽  
Author(s):  
B MASCRET ◽  
D MARANINCHI ◽  
J GASTAUT ◽  
J CAMERLO ◽  
G NOVAKOVITCH ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
Lymphocytic Leukemia ◽  
High Dose ◽  
Autologous Bone ◽  
High Dose Melphalan

scholarly journals Monoclonal antibody-purged autologous bone marrow transplantation therapy for multiple myeloma

Blood ◽  
1991 ◽  
Vol 77 (4) ◽  
pp. 712-720 ◽  
Author(s):  
KC Anderson ◽  
BA Barut ◽  
J Ritz ◽  
AS Freedman ◽  
T Takvorian ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Plasma Cells ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Autologous Bone ◽  
High Dose Melphalan

Abstract Eleven patients with plasma cell dyscrasias underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MoAb)-treated autologous bone marrow transplantation (ABMT). The majority of patients had advanced Durie-Salmon stage myeloma at diagnosis, all were pretreated with chemotherapy, and six had received prior radiotherapy. At the time of ABMT, all patients demonstrated good performance status with Karnofsky score of 80% or greater and had less than 10% marrow tumor cells. Eight patients had residual monoclonal marrow plasma cells and 10 patients had paraprotein. Following high-dose melphalan and total body irradiation (TBI) there were seven complete responses, three partial responses, and one toxic death. Granulocytes greater than 500/mm3 were noted at a median of 21 (range 12 to 46) days posttransplant (PT) and untransfused platelets greater than 20,000/mm3 were noted at a median of 23 (12 to 53) days PT in 10 of the 11 patients. Natural killer cells and cytotoxic/suppressor T cells predominated early PT, with return of B cells at 3 months PT and normalization of T4:T8 ratio at 1 year PT. Less than 5% polyclonal marrow plasma cells were noted in all patients after transplant. Three of the seven complete responders have had return of paraprotein, two with myeloma, and have subsequently responded to alpha 2 interferon therapy. Eight patients are alive at 18.9 (8.9 to 43.1) months PT and four remain disease-free at 12.3, 17.5, 18.9, and 29 months PT. This preliminary study confirms that high-dose melphalan and TBI can achieve high response rates without unexpected toxicity in patients who have sensitive disease, and that MoAb-based purging techniques do not inhibit engraftment. Although the follow-up is short- and long-term outcome to be determined, relapses post-ABMT in these heavily pretreated patients suggest that ABMT or alternative treatment strategies should be evaluated earlier in the disease course.

scholarly journals High-dose chemoradiotherapy and autologous bone marrow transplantation for resistant multiple myeloma

Blood ◽  
1987 ◽  
Vol 70 (3) ◽  
pp. 869-872 ◽  
Author(s):  
B Barlogie ◽  
R Alexanian ◽  
KA Dicke ◽  
G Zagars ◽  
G Spitzer ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Autologous Bone ◽  
Total Body ◽  
High Dose Melphalan

Abstract Seven patients with advanced multiple myeloma, refractory to therapy with alkylating agent-VAD (vincristine-adriamycin-dexamethasone), received a regimen combining high-dose melphalan with total body irradiation supported by autologous bone marrow transplantation. Very rapid, usually greater than 90% tumor mass reduction was achieved in six patients, regardless of prior chemotherapy responsiveness and marrow plasmacytosis up to 30%. Despite signs of early relapse in three patients (median remission duration of all patients, 15 months), five remain alive and well without further cytotoxic therapy from 2 to 21 months (median, 9+ months). Two patients died, one from surgical complications after transplantation and a second due to persistent neutropenia with fatal pneumonia. This treatment provides meaningful disease control for selected patients with resistant myeloma and a poor prognosis.

POEMS Syndrome: A Patient with an IgA lambda Plasma Cell Disease. Expression Levels of VEGF and bFGF Correlates with Clinical Course.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5516-5516
Author(s):  
Carsten Schrader ◽  
Markus Tiemann ◽  
Ute Zirrgiebel ◽  
Andreas Guenther ◽  
Dirk Janssen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Plasma Cells ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
Poems Syndrome ◽  
High Dose ◽  
Autologous Bone ◽  
High Dose Melphalan

Abstract Purpose: POEMS syndrome is a rare disease characterized by polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes. We present a severely ill woman with a four year history of polyneuropathy showing all signs of a POEMS syndrome. Response to chemotherapy including high-dose melphalan treatment and autologous bone marrow transplantation was monitored and vascular endothelial growth factor (VEGF) as well as basic fibroblast growth factor (bFGF) levels were measured. Methods: Blood investigation was done for serum electrophoresis analysis and analysis of VEGF, bFGF and IL-6 by ELISA. Bone marrow biopsy specimen was investigated immunohistochemically for kappa, lambda, alpha, gamma, CD20, CD56, Cyclin D1, VEGF. Results: Immunohistochemical investigation of the bone marrow biopsy showed a infiltration of lambda and alpha positive plasma cells (10%). Only few plasma cells expressed kappa. The tumor cell were negative for CD20, CD56 and Cyclin D1, but positive for VEGF in line with the high VEGF levels in the blood. Blood investigation revealed a discrete monoclonal gammopathy of IgA lambda type. Initially, high levels of VEGF (1468.7 pg/ml) and bFGF (112.9 pg/ml) were detected. However, treatment with high-dose melphalan and tandem autologous bone marrow transplantation proved extremely helpful in symptom control. Already after the first transplant the patient started to walk again and lost pulmonary hypertension. In parallel VEGF and bFGF levels decreased and the performance status of the patient improved dramatically. Conclusion: VEGF and bFGF measurement is a useful tool for monitoring disease activity in POEMS syndrome. Bone marrow transplantation is an important therapy also in severely ill patients.

Repeated high dose melphalan and autologous bone marrow transplantation (ABMT) in ANLL

1986 ◽  
Vol 10 (1) ◽  
pp. 113
Author(s):  
B. Mascret ◽  
D. Maraninchi ◽  
J.A. Gastaut ◽  
N. Tubiana ◽  
H. Perrimond ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Autologous Bone ◽  
High Dose Melphalan

scholarly journals Monoclonal antibody-purged autologous bone marrow transplantation therapy for multiple myeloma

Blood ◽  
1991 ◽  
Vol 77 (4) ◽  
pp. 712-720 ◽  
Author(s):  
KC Anderson ◽  
BA Barut ◽  
J Ritz ◽  
AS Freedman ◽  
T Takvorian ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Plasma Cells ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Autologous Bone ◽  
High Dose Melphalan

Eleven patients with plasma cell dyscrasias underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MoAb)-treated autologous bone marrow transplantation (ABMT). The majority of patients had advanced Durie-Salmon stage myeloma at diagnosis, all were pretreated with chemotherapy, and six had received prior radiotherapy. At the time of ABMT, all patients demonstrated good performance status with Karnofsky score of 80% or greater and had less than 10% marrow tumor cells. Eight patients had residual monoclonal marrow plasma cells and 10 patients had paraprotein. Following high-dose melphalan and total body irradiation (TBI) there were seven complete responses, three partial responses, and one toxic death. Granulocytes greater than 500/mm3 were noted at a median of 21 (range 12 to 46) days posttransplant (PT) and untransfused platelets greater than 20,000/mm3 were noted at a median of 23 (12 to 53) days PT in 10 of the 11 patients. Natural killer cells and cytotoxic/suppressor T cells predominated early PT, with return of B cells at 3 months PT and normalization of T4:T8 ratio at 1 year PT. Less than 5% polyclonal marrow plasma cells were noted in all patients after transplant. Three of the seven complete responders have had return of paraprotein, two with myeloma, and have subsequently responded to alpha 2 interferon therapy. Eight patients are alive at 18.9 (8.9 to 43.1) months PT and four remain disease-free at 12.3, 17.5, 18.9, and 29 months PT. This preliminary study confirms that high-dose melphalan and TBI can achieve high response rates without unexpected toxicity in patients who have sensitive disease, and that MoAb-based purging techniques do not inhibit engraftment. Although the follow-up is short- and long-term outcome to be determined, relapses post-ABMT in these heavily pretreated patients suggest that ABMT or alternative treatment strategies should be evaluated earlier in the disease course.

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