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212 Chapter 5: Myeloma (0 n o B co d CvJ d q d Overall Survival from Time of Allogeneic BMT Years Progression-free Survival from Time of Allogeneic BMT 03 d == ° to .Q o d Figure 1. Progression free and overall survival after CD6 depleted allogeneic bone marrow transplantation for multiple myeloma.
Schlossman et al. 213 Cohorts of patients received 0.3, 1.0, and 1.5X 10 8 CD4 + cells/kg. Responses were seen in 15 of 19 (79%) patients with early relapsed CML. Of note, five of six (83%) évaluable patients with MM responded (three CR and two PR) at a median of 26 (18-62) weeks after DLL Responses were associated with GVHD in three cases, but in two patients there were no clinical or laboratory abnormalities consistent with GVHD. Three responders progressed at 26, 38, and 62 weeks post-DLL Given the high response rates but inevitable relapses observed in the setting of allografting for MM, 9 - 1 0 , 1 2 2 5 ' we are using CD4 + DLI at 6 months after CD6depleted BMT to treat MRD posttransplant and thereby improve outcome. Patients who are 6-9 months post-CD6 allografting and who have less than grade 2 GVHD are eligible to receive CD4 + DLL To date, 17 patients have undergone CD6depleted allografting, and 12 patients developed grades 0-1 GVHD. Six of these patients are >6 months post-BMT and have received CD4 + DLI. After CD4 + DLI, three patients each have developed grades 0-1 GVHD and grades 2-4 GVHD. There are two CR, two PR, and two patients too early to evaluate post-CD4 + DLI. Autologous HSCT We have carried out autografting (using mAb-purged BM or CD34 + PBPCs) in 105 patients with MM whose disease remained sensitive to conventional chemotherapy. 22-25 This includes 68 men and 37 women with median age of 52 (30-69) years. At the time of diagnosis, 19 (18%), 16 (15%), 52 (50%), and 15 (14%) patients had stages IA, IIA, IIIA, and MB disease, respectively; three (3%) patients presented with plasmacytomas. Median time to neutrophil engraftment was 22 (10-53) and 11 (8-17) days in recipients of autologous BM and PBSCs, respectively. Median time to platelet engraftment was a median of 29 (10-371) and 13 (8-97) days in recipients of autologous BM and PBSC grafts, respectively. There were 31 (30%) CR, 64 (62%) PR, three (3%) NR, and one (1%) toxic death; four (4%) patients are too early to evaluate. Median PFS is 2.2 years, with median OS from time of BMT of 4.2 years (Fig. 2). The PFS and OS of patients treated at our institute do not significantly differ (Fig. 3). DISCUSSION High-dose therapy followed by allografting is associated with high response rates but no cures in MM. Allogeneic stem cell grafting is further limited by excessive toxicity. By using CD6 depletion, we are attempting to achieve MRD in MM using allografting and developing immune therapies to treat MRD posttransplant and thereby achieve long-term disease-free survival and potential cure. Our first efforts are to use CD6 T cell-depleted allografts to abrogate GVHD and then use CD4 + DLI to augment GVM posttransplant. The use of DLI to treat
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AUTOLOGOUS BLOOD AND MARROW TRANSPL
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AUTOLOGOUS BLOOD AND MARROW TRANSPL
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ACKNOWLEDGMENTS We wish to thank Wi
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THE VAN BEKKUM STEM CELL AWARD Prof
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xii Table of Contents CHAPTER 2: AL
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xiv Table of Contents Late Non-Rela
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xvi Table of Contents Pretreatment
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xviii Table of Contents CHAPTER 7:
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XX Table of Contents Long-Term Obse
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xxii Table of Contents CHAPTER 13:
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0-9 LIST OF ABBREVIATIONS 2CDA 2-ch
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List of Abbreviations xxvii EFS eve
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List of Abbreviations MOPP mechlore
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VOD veno-occlusive disease VPC viru
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4HC-Purged Autologous Stem Cell Tra
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1.0-1 + 0.2 Miller et al. 5 Event F
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Miller et al. Adjusted probability
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Who Benefits From Autograft in AML
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Burnett 11 which to set the transpl
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Table 1. Outcome after relapse in M
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Immunotherapy in AML: No Positive E
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Simonsson et al. inhibit IL-2 induc
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Autologous Bone Marrow Transplantat
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Ball et al. 21 CD15) and AML-2-23 (
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Ball et al. 23 The ex vivo treatmen
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Ball et al. 25 Table 2. Factors inv
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Ball et al. Overall Survival for Pa
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Ball et al. Overall Survival for Pa
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Ball et al. 31 Overall Survival for
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Ball et al. Table 4. Actuarial over
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Ball et al. myeloid leukemia. The G
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Ball et al. 1993. 38. Mehta J, Powl
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Can Autologous Stem Cell Transplant
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De Witte et al. 41 novo AML. Auer r
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De Witte et al. hematopoietic engra
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De Witte et al. 23. Fenaux P, Laï
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Stein et al. and fever. No patient
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Stein et al. after doses 1, 3, and
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Stein et al. early after the transp
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autologous stem-cell rescue. / Clin
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Bone Marrow Transplantation for Acu
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Table 2. Autologous BMT in ALL in f
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Rowe 61 or adult patients with acut
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Hoelzer and Gôkbuget minitransplan
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Hoelzer and Gdkbuget 65 blood, earl
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Table 3. Risk factors for the defin
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Hoelzer and Gôkbuget treatment opt
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Hoeker and Gökbuget tical sibling
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Sierra et al. INTRODUCTION Two-thir
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Sierra et al. Table 2. Adverse char
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1,0 0,0 J Sierra et al. 0 20 40 60
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Sierra et al. Months Figure 4 < 30,
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Sierra et al. No adverse factors (n
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1994. Sierra et al. 83 10. Canals C
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Martin, Atta, and Hoelzer 85 adult
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Martin, Atta, and Hoelzer 87 Single
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100. Martin, Atta, and Hoelzer 89 P
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Martin, Atta, and Hoelzer 91 chromo
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Autologous vs. Unrelated Allogeneic
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Boyer and Yeager 95 outcomes after
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Boyer and Y eager 97 Table 2. Hypot
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Boyer and Y eager SUMMARY Most of t
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CHAPTER 3 CML
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Autograft Followed by Allograft Wit
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106 Chapter 3: CML (one low-grade a
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108 Chapter 3: CML DISCUSSION Myelo
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110 Chapter 3: CML Philadelphia-neg
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The Case for Manipulation of CML Au
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Toward a Cure by Drug Treatment? Th
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116 Chapter 3 :CML Table 1. Prolong
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118 Chapter 3: CML Table 3. German
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120 Chapter 3: CML Table 5. Normal
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122 Chapter 3: CML Table 8. Surviva
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124 Chapter 3: CML 88:3118-3122, 19
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126 Chapter 3: CML RK, Klingemann H
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The Tyrphostin AG957 Inhibits the I
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130 Chapter 3: CML mobilization. Al
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132 Chapter 3: CML A B 100 n 0 1 5
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134 Chapter 3: CML The in vitro sel
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136 Chapter 3: CML detecting leukem
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Progressive Hodglcin's Lymphoma Fol
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Reece et al. survival is observed i
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0.2 -I 0.0 0 Reece et al. 143 ii i
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Reece et al. Table 3. Causes of non
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Reece et al. carmustine, etoposide
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CD34 + Selection of Hematopoietic B
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Lazarus et al. 151 significantly de
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Lazarus et al. 153 (Sigma, St Louis
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Lazarus et al. 155 Table 2. Effect
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Lazarus et al. 157 difference. Furt
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Lazarus et al. 159 cells after myel
Page 195 and 196: The European CUP/UP Trial: A Prelim
Page 197 and 198: Table 1. Patient characteristics at
Page 199 and 200: Schouten et al. licular non-Hodgkin
Page 201 and 202: Sweetenham et al. vs. autologous pe
Page 203 and 204: Table 1. Patient characteristics, g
Page 205 and 206: Table 2. Patient characteristics, g
Page 207 and 208: Table 3. Sites of relapse, group A
Page 209 and 210: Table 4. Patterns of relapse, group
Page 211 and 212: A 100 80 %OS 60 40 20 B 100 %OS | S
Page 213 and 214: Sweetenham et al. new sites, and fi
Page 215 and 216: Sweetenham et al. Treatment options
Page 217 and 218: Molecular Remission: A Worthwhile A
Page 219 and 220: Early or Late Autotransplant in Hig
Page 221 and 222: Schenkein et al. 187 PATIENTS AND M
Page 223 and 224: Schenkein et al. 189 Toxicity Toxic
Page 225 and 226: Schenkein et al. 191 16. Glick JH,
Page 227 and 228: Santini et al. 193 to evaluate the
Page 229 and 230: Table 1. Continued Santini et al. 1
Page 231 and 232: Santini et al. 197 cytosine arabino
Page 233 and 234: 1 0 0 1 90- 80- 70- (0 u. 60' o so-
Page 235 and 236: Hodgkin's lymphoma. N EnglJ Med 333
Page 237: CHAPTER 5 MYELOMA
Page 240 and 241: 206 Chapter 5: Myeloma independent
Page 242 and 243: 208 Chapter 5: Myeloma disease (MRD
Page 244 and 245: 210 Chapter 5: Myeloma Scandinavia,
Page 248 and 249: 214 Chapter 5: Myeloma B cq d ? o c
Page 250 and 251: 216 Chapter 5: Myeloma patients wit
Page 252 and 253: 218 Chapter 5: Myeloma PBSC transpl
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Page 256 and 257: Autologous Transplantation in Multi
Page 258 and 259: 224 Chapter 5: Myeloma 0 52 44 U §
Page 260 and 261: 226 Chapter 5: Myeloma BM ^ (CD34±
Page 262 and 263: 228 Chapter 5: Myeloma IFM 94 : OS
Page 264 and 265: 230 Chapter 5: Myeloma two groups a
Page 266 and 267: 232 Chapter 5: Myeloma increase bot
Page 268 and 269: 234 Chapter 5: Myeloma REFERENCES 1
Page 270 and 271: 236 Chapter 5: Myeloma Intensified
Page 272 and 273: 238 Chapter 5: Myeloma of CD34 + ce
Page 274 and 275: Chapter 5: Myeloma Table 2. Descrip
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Page 278 and 279: 244 Chapter 5: Myeloma ated with sh
Page 281 and 282: The Presence of Micrometastases in
Page 283 and 284: Kvalheim et al. 249 Table 1. Immuno
Page 285 and 286: Kvalheim et al. 251 Figure 1. Sixty
Page 287 and 288: Kvalheim et al. 253 DISCUSSION In t
Page 289 and 290: Kvalheim et al. 255 Bastert G: Micr
Page 291 and 292: Hood et al. 257 In an effort to inc
Page 293 and 294: #CD34 + cells in blood = Hood et al
Page 295 and 296: Hood et al. 261 Table 3. Frequency
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Hood et al. 263 REFERENCES 1. Rill
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The Clinical Significance of Breast
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Moss et al. tests, and bilateral po
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Moss et al. 269 0 15 70 143 200 400
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Moss et al. 271 0 3 6 12 18 24 30 3
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Moss et al. 273 8. Passos-Coelho J,
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Autotransplantation for Men With Br
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McCarthy et al. 277 radiation, two
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High Dose Sequential Chemotherapy W
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Viens et al. 281 3 g/m 2 and doxoru
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Table 1. Tumor characteristics Exte
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Table 4. Response Viens et al. 285
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Viens et al. 287 Table 5. Pathologi
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Viens et al. 289 apy for inoperable
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Gliick et al. 291 INTRODUCTION The
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Gluck et al. 293 RESULTS Patient de
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Glück et al. 295 Table 3. Response
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Gluck et al. 297 Overall Survival O
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Gluck et al. 299 Sudbury patients w
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Gluck et al. 301 anthracycline or t
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Repetitive High-Dose Therapy With P
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Prince et al. paramagnetic separati
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Prince et al. Table 1. High-dose re
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Table 2. Patient characteristics (n
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Table 4. Hematopoietic recovery fol
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1.0- M C .S 0.8- a c *fe o o> 0.6-
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M 1.0 I 0.8H s? VI o.6H S 0.2 0.0 P
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a Prince et al. days to platelets >
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Table 5. Results of Isolex 300i CD3
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Prince et al. 321 Figure 5, continu
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Prince et al. 323 months after tran
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Prince et al. 325 excessive to be u
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Prince et al. 327 eight patients ha
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Prince et al. 329 marrow transplant
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Prince et al. intensive chemotherap
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-Q CO .Q O 1.0 0.9 0.8 0.7 0.6 0.5
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.Q CD .Q O 1.0 0.9 0.8 0.7 0.6 0.5
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oba Q. 1.0 0.9 Dicke et al. Stage I
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Vahdat with peripheral blood progen
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Evaluation of Prognostic Factors fo
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Fields et al. 343 PATIENTS AND METH
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Table 1. Chemotherapy regimens. Fie
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Fields et al. Stage II; 4-9 Pos LN
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U U Fields et al.
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Fields et al. 351 between 1 and 2 y
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European Trends and the EBMT Databa
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25% % 22% / 17% \ Rosti et al. 355
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Rosti et al. 357 The new Italian St
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Rosti et al. 6. Haas R, Schmid H, H
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Bewick et al. 363 INTRODUCTION The
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Bewick et al. 365 Blood samples obt
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Bewick et al. 367 HDCT with ABSC su
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Bewick et al. Progression Free Surv
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Bewick et al. pression in MBC, i.e.
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Bewick et al. 14. Kandl HL, Seymour
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CHAPTER 7 OTHER SOLID TUMORS
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378 Chapter 7: Solid Tumors INTRODU
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380 Chapter 7: Solid Tumors Prepara
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382 Chapter 7: Solid Tumors Surviva
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384 Chapter 7: Solid Tumors months
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386 Chapter 7: Solid Tumors have be
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High-Dose Chemotherapy in the Manag
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390 Chapter 7: Solid Tumors followe
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392 Chapter 7: Solid Tumors Table 1
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394 Chapter 7: Solid Tumors (mucosi
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Three-Fold Intensification by Seque
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High-Dose Therapy for Small Cell Lu
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404 Chapter 7: Solid Tumors chemoth
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406 Chapter 7: Solid Tumors SCLC ha
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408 Chapter 7: Solid Tumors relapse
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410 Chapter 7: Solid Tumors 69:585-
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412 Chapter 7: Solid Tumors ogous b
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414 Chapter 7: Solid Tumors 64. Bru
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416 Chapter 7: Solid Tumors Prignot
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418 Chapter 7: Solid Tumors CO > CO
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420 Chapter 7: Solid Tumors TANDEM
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Multiple Courses of Cyclophosphamid
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424 Chapter 7: Solid Tumors and the
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426 Chapter 7: Solid Tumors Thiotep
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430 Chapter 7: Solid Tumors E 100 0
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432 Chapter 7: Solid Tumors course
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434 Chapter 7: Solid Tumors boplati
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436 Chapter 7: Solid Tumors INTRODU
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438 - Chapter 7: Solid Tumors Table
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440 Chapter 7: Solid Tumors seeded
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442 Chapter 7: Solid Tumors DISCUSS
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444 Chapter 7: Solid Tumors 10. Di
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446 Chapter 7: Solid Tumors plasma
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Autologous Stem Cell Transplantatio
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Keystone 451 hypertension, anemia,
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Fassas et al. 453 INTRODUCTION Mult
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Fassas et al. Table 2. Stem cell mo
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Table 3. Toxicity after stem cell i
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Fassas et al. Table 5. Trial 1: cha
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Fassas et al. MS PROGRESSION FREE S
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Fassas et al. ic or autologous bone
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1 2 1 6 EAE. Burt et al. 465 Becaus
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Burt et al. Since cyclophosphamide
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Burt et al. 469 toxicity study, we
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Burt et dl. All 23. Mor F, Cohen IR
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Hasler, Gratwohl, and Tyndall an ev
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Hasler, Gratwohl, and Tyndall 475 B
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Kuis, Wulffraat, and Sanders 477 st
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Kuis, Wulffraat, and Sanders neousl
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CHAPTER 9 LONG-TERM EFFECTS
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484 Chapter 9: Long-Term Effects po
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486 Chapter 9: Long-Term Effects Ta
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488 Chapter 9: Long-Term Effects ml
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490 Chapter 9: Long-Term Effects 4.
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492 Chapter 9: Long-Term Effects us
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494 Chapter 9: Long-Term Effects AB
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498 Chapter 9: Long-Term Effects En
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500 Chapter 9: Long-Term Effects Rl
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502 Chapter 9: Long-Term Effects RE
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504 Chapter 9: Long-Term Effects A,
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Long-Term Follow-Up of Autologous T
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CHAPTER 10 GRAFT MANIPULATION
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514 Chapter 10: Graft Manipulation
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Stem Cell Reinfusion Over Two Conse
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Final Report of the First Prospecti
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Canine Hematopoietic Stem Allograft
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Sandmaier et al. 603 The resultant
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Sandmaier et al. 605 synthesis path
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Sandmaier et al. 607 interactions o
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Sandmaier et al. 1991. 2. Burchenal
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87:3508-3513,1996. Sandmaier et al.
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Giralt, Khouri, and Champlin Table
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Giralt, Khouri, and Champlin seven
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1.0 3 0.2 Giralt, Khouri, and Champ
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CHAPTER 12 GENE THERAPY
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622 Chapter 12: Gene Therapy INTROD
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624 Chapter 12: Gene Therapy RESULT
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626 Chapter 12: Gene Therapy envisi
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628 Chapter 12: Gene Therapy cer in
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A Vaccine of Melanoma Peptide Loade
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B43(anti-CD 19)-Gen i stein Immunot
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Targeting Immunotherapy for the Tre
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McGuinness andArceci 637 modified m
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McGuinness andArceci 639 leukemic c
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McGuinness and Arced 641 in G418. T
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McGuinness andArceci 643 Figure 2
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mRNA for hB7-1 (1491 bp) mRNA for C
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McGuinness and Arced CD80PE C080PE
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McGuinness andArceci 649 8. Robert
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McGuinness andArceci immune respons
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McGuinness andArceci 75. Jubinsky F
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Slavin et al. 655 up suggests, as p
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Slavin et al. 657 was a phase lib c
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Slavin et al. presented, appears to
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Antitumor Immunotherapy in Autologo
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Klingemann et al. 663 Table 3. Meth
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CHAPTER 14 RADIOIMMUNOTHERAPY
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668 Chapter 14: Radioimmunotherapy
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Selection of Radioisotopes, Chelate
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Radioimmunotherapy of Common Epithe
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CHAPTER 15 NEW AVENUES
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698 Chapter 15: New Avenues Table 1
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700 Chapter 15: New Avenues An alte
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702 Chapter 15: New Avenues who can
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704 Chapter 15: New Avenues myeloid
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706 Chapter 15: New Avenues 48. Gir
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Emerging Viral Infections in Blood
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710 Chapter 15: New Avenues influen
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712 Chapter 15: New Avenues Among a
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714 Chapter 15: New Avenues physica
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716 Chapter 15: New Avenues respira
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Minimal Therapy Models of Transplan
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CHAPTER 16 SUMMARIES
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724 Chapter 16: Summaries although
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726 Chapter 16: Summaries use of po
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728 Chapter 16: Summaries Table 1.
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736 Chapter 16: Summaries IL-15. Th
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738 Chapter 16: Summaries Patterns
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740 List of Participants Thomas L.
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742 List of Participants Sergio A.
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744 List of Participants Hans Marti
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746 List of Participants David P. S
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748 List of Participants AUTHOR IND
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750 Author Index Hurd, D.D. 483 Kui
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752 Author Index Stiff, Patrick J.
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754 Key Word Index Hematologic mali
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ISBN 1-891524-04-6
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