autologous blood and marrow transplantation - Blog Science ...

De Witte et al.
hematopoietic engraftment was also slower in these seven patients, but all patients
engrafted except for one patient who died early before engraftment of treatment-
related causes. Two patients were alive and well at 10 and 28 months after
autoBMT. 30
Demuynck et al. 33
investigated the feasibility of collecting peripheral stem cells
in 11 patients with myelodysplasia. This resulted in seven patients with an adequate
yield (>1 X 10 6
/kg) of CD34 cells. 32
Three patients with a normal to excellent stem
cell harvest were demonstrated to be polyclonal by PCR techniques based on Xchromosome
inactivation patterns. 27
Sixteen patients received autologous
peripheral blood SCT in a prospective study of the EORTC Leukemia Cooperative
Group and the EBMT. 34
Peripheral stem calls were collected during the recovery
phase of the first consolidation course using 300 ug filgrastim (subcutaneously)
daily until completion of PBSC collections. Preliminary data indicate that the
repopulation was much faster compared with autoBMT. 27
' 33-35
Autologous SCT
has emerged as a treatment option for patients with myelodysplastic syndromes or
acute myeloid leukemia evolved from MDS. Only patients who are in complete
remission after intensive chemotherapy are considered as candidates for autoSCT.
About one-quarter of the patients with autologous stem cells may be free of disease
for 3 years or longer. The high treatment-related mortality contributes substantially
to this result, which is inferior to the results obtained by transplantation for de novo
AML. Prospective, multicenter studies may reveal which categories of patients
with MDS will benefit from intensive chemotherapy followed by autoSCT. This
treatment approach has to be assessed against the merits and disadvantages of
allogeneic stem cell transplantation with donors other than HLA-identical siblings.
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