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Gorin 499<br />

ABMT IN AL<br />

Outcome in relation to stem cell dose treated in vitro<br />

SURVIVAL<br />

J Il II 1 Ml I UN,<br />

Dose > 5.46 10 4<br />

CFUGM/kg (n=104)<br />

' ' " ' " u<br />

"^••L-U-.H, .. Dose55.46 10 4<br />

CFUGM/kg (n=103)<br />

Figure 4<br />

p = 0.0003<br />

3 4 5 Months s<br />

CTU Paris, St Antoine<br />

receiving higher <strong>marrow</strong> doses evaluated prepurging <strong>and</strong> lower residual doses<br />

postpurging. Patients with the reverse were in the worst group (group 3: OS 22 ±<br />

8%). In the intermediate group (group 2), one of the two <strong>marrow</strong> dose character­<br />

istics was nonoptimal (lower <strong>marrow</strong> dose prepurging or higher residual <strong>marrow</strong><br />

dose postpurging); younger patients, however, had a better OS (intermediate/good:<br />

57 ± 7%) than older patients (intermediate/poor: 44 ± 7%).<br />

CONCLUSION<br />

Tables 9 <strong>and</strong> 10 summarize factors predicting for faster engraftment <strong>and</strong> factors<br />

predicting for better outcome. With these factors a model was built.<br />

This model led to simple <strong>and</strong> useful messages: it clearly showed that by<br />

combining the infusion of a rich <strong>marrow</strong> aggressively purged by mafosfamide<br />

within safe margins as ensured by the AD technique <strong>and</strong> carefully monitored for<br />

optimal cryopreservation, secure engraftment can be obtained <strong>and</strong> outcome<br />

improved with less TRM <strong>and</strong> better LFS <strong>and</strong> OS. Initial diagnosis, patient age,<br />

<strong>marrow</strong> richness, purging intensity, <strong>and</strong> cryopreservation efficiency are the key<br />

factors to consider before starting an autograft. As a consequence of this study, we

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