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162 ABMT in ALL Sanofi Recherche, Montpelier. The purged marrow was stored at - 196° C (7). When in remission patients received at least two consolidation treatments with Vincristine 1,5 mg/m 2 x 1, Daunorubicine 30 mg/m 2 x 1, Prednisone 60 mg/m 2 x 5, Etoposide 100 mg/m 2 x 5 and Ara-C 100 mg/m 2 b.d. x 5. The myeloablative regimen was Prednisone 100 mg/m days -6 and -5, Tenippside 200 mg/m 2 day -6, Vincristine 1,5 mg/m 2 day -6, Ara-C 500 mg/m 2 days -6 to -2, Daunorubicine 30 mg/m 2 day -6, Cyclophosphamide 40 mg/kg days -4 and -3, and TBI 750 cGy (midline dose rate 15 cGy/min) day -1. The numbers of reinfused MNC and CFU-GM were 0.27 (0.13 - 0.89) x 10 8 /kg and 4.2 (1.1-10) x 10 4 /kg respectively. RESULTS Treatment of leukemic cells with MAbs and complement resulted, except in 1 case, in > 4 log target cell killing. After purging in full scale no TdT-positive cells were detected. All patients engrafted. Median time to neutrophil count > 0,5 x 10 9 /1 was 26 days and to platelets > 50 x 10 9 /1 37 days. Fifteen percent of the patients had not reached this platelet count level after 90 days. No patient died of transplant related complications. All patients had fever during aplasia, 3 together with bacterial septicaemia and 4 with pneumonia. One patient had VOD which completely reversed, and 2 patients interstitial nephritis, which in one case was fully reversible. One patient, in remission, died in pneumonia 8 months after ABMT. The patient transplanted in relapse engrafted, but died in a new relapse after 2 months. Figure 1 shows a 53% leukemia free survival from CR for 9 patients autografted in CR 1. Median time from CR to ABMT was 7 (3-12) months. Four patients have relapsed 6,5-17,5 months and 1 patient, in CR, died in pneumonia 20 months after achieving CR. One relapsed patient went into a new CR after BMT. Figure 2 shows two different curves of the 17 patients autografted in CR 2-3; the proportion of relapses in previous CR and the probability of remaining in the present CR (in which ABMT was performed). The time from diagnosis to relapse range 5-70 months and the median duration of present CR is 34 months. The effect of ABMT can also be illustrated by comparing previous CR time with time in new CR including time post ABMT. If the latter is longer than the former the patient is said to have "inverted," suggesting a beneficial effect of ABMT. Five patients have "inverted" with another 8 patients yet to achieve the "inversion point." Table 1 shows that both the great majority of relapses (5/7), and "inversions" (5/5) have occurred in patients with "fast disease" (i.e. relapsed on chemotherapy).
ABMT in ALL 163 10< 5
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Autologous Bone Marrow transplantat
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AUTOLOGOUS BONE MARROW TRANSPLANTAT
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Contents Preface xxi Acknowledgment
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High Dose Etoposide, Melphalan, Tot
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High-Dose Therapy and Autologous Bo
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Autologous Bone Marrow Transplantat
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Breast Tumor Cell Detection in Marr
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High Dose Chemo-Radiotherapy with B
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The Use of Recombinant Human Granul
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Session VIII - Further Developments
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Acknowledgments Publication of thes
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CBV and ABMT for AML in CRI 3 DOES
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CBV and ABUT for AML in CR1 5 Bone
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CBV and ABMT for AML in CR1 7 27 36
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CBV and ABMT for AML in CR1 Table 3
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CBV and ABMT for AML in CRI 11 ACKN
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Mafosfamide Purging in Acute Leukem
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Timing of BMT for ANL 21 TIMING OF
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Timing of BMT for ANL 23 Unlike che
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Timing of BMT for ANL 25 autologous
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Timing of Bone Marrow Transplantati
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Merocyanine-540 and Mafosfamide Pur
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Merocyanine-540 and Mafosfamide Pur
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Merocyaniñe-540 and Mafosfamide Pu
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Sensitivity of Leukemic Progenitors
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38 Sensitivity of Leukemic Progenit
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ABMT for Consolidation of AML/ALL i
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56 Hematopoietic Progenitor Selecti
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62 Acute Leukemia - AML (Purging) (
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64 Acute Leukemia - AML (Purging) T
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4HC/VCR Chemopurge 67 CHEMOPURGE WI
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4HC/VCR Chemopurge 69 Table 1. Pati
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4HC/VCR Chemopurge 71 remain in rem
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Autologous BMT for ANLL 73 AUTOLOGO
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Autologous BMT for ANLL 75 Hematolo
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Autologous BMT for ANLL 77 in CR2 o
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Clinical Value of Auto BMT 79 Discu
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BAVC and ABMT in AML Patients 81 BA
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BAVC and ABMT in AML Patients 83 Bo
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BAVC and ABMT in AML Patients 85 Ta
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ABMT in Advanced ALL 87 RESULTS OF
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ABMT in Advanced ALL 89 After hemat
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ABMT in Advanced ALL 91 Two differe
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94 Autograft for AML Since no concl
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96 Autograft for AML 8 16 24 32 40
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98 Autograft for AML relapse free p
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Etoposide, Melphalan, TBI and ABMT
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108 J In Vitro/In Vivo Treatment of
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110 In Vitro/In Vivo Treatment of L
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Page 140 and 141: 114 BU/CY in BMT CY alone is not an
Page 142 and 143: 116 BU/CY in BMT BU CY PREPARATIVE
Page 144 and 145: 118 BU/CY in BMT autologous or allo
Page 146 and 147: 120 Double AML Transplants consolid
Page 148 and 149: 122 Double AML Transplants 100 Even
Page 150 and 151: 124 Double AML Transplants There is
Page 152 and 153: 126 Double Transplants and 21 had a
Page 154 and 155: 128 Double Transplants (ALL) and fu
Page 156 and 157: 130 Double Transplants PROSPECTIVE
Page 158 and 159: 132 Double Transplants months (22-7
Page 161 and 162: Autologous vs. Allogeneic Transplan
Page 163: SESSION I - LEUKEMIA B. ACUTE LEUKE
Page 166 and 167: 140 ABMT vs. Chemotherapy in High R
Page 172 and 173: 146 Marrow Transplantation for ALL
Page 174 and 175: 148 Marrow Transplantation for ALL
Page 177 and 178: ABMT Italian Study for Childhood AL
Page 179 and 180: ABMT Italian Study for Childhood AL
Page 181 and 182: Autologous Transplant for ALL 155 A
Page 183 and 184: Autologous Transplant for ALL 157 R
Page 185 and 186: Autologous Transplant for ALL 159 n
Page 187: ABMT in ALL 161 AUTOLOGOUS BONE MAR
Page 191 and 192: ABMT in ALL 165 NATIONAL SWEDISH AL
Page 193 and 194: ABMT in ALL 167 AUTOLOGOUS BONE MAR
Page 195: ABMT in ALL 169 98 X tlx 7IX (IX SI
Page 198 and 199: 172 B43/CD19 PAP IT Table 1. Expres
Page 200 and 201: 174 B43/CD19 PAP IT dialyzed, and f
Page 202 and 203: Figure 2. Biochemical Analysis of B
Page 204 and 205: 178 B43/CD19 PAP IT 15. Uckun FM, K
Page 206 and 207: 180 Detection of Minimal Residual D
Page 214 and 215: 188 Autologous BMT vs. Chemotherapy
Page 216 and 217: 190 Autologous BMT vs. Chemotherapy
Page 218 and 219: 192 Autologous vs. Allogeneic Trans
Page 220 and 221: 194 Timing & Conditioning Regimens
Page 222 and 223: 196 Timing & Conditioning Regimens
Page 225 and 226: Purging with Anti-B Cell MoAb and C
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Page 233 and 234: Front Line Chemotherapy Regimens 20
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Front Line Chemotherapy Regimens 21
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Front Line Chemotherapy Regimens 21
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218 Optimal Timing for ABMT in Non-
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ABMT in NHL and HD — Timing of Th
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ABMT in NHL and HD - - Timing of Th
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ABUT in NHL and HD — Timing of Th
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The Role of Intensive Chemotherapy
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(H S m ¡3 < Xi •P •ri Se X tri
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242 Optimal Timing for Intermediate
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244 Optimal Timing for Intermediate
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BMT for Lymphoblastic Lymphoma 247
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High Dose Therapy for Multiple Myel
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Hodgkin's Disease, ABMT 261 OPTIMAL
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Hodgkin's Disease, ABMT 263 Table 1
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Hodgkin's Disease, ABMT 265 Table 3
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Hodgkin's Disease, ABMT 267 REFEREN
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270 Timing of ABMT in Hodgkin's Dis
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272 Timing of ABMT in Hodgkin's Dis
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Timing of CBV and Autologous BMT 27
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286 High Dose Chemotherapy Regimens
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Optimal Timing for Lymphoblastic Ly
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Optimal Timing for Lymphoblastic Ly
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298 Optimal Timing for Hodgkin's TB
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300 BMT Preparative Regimens marrow
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302 BMT Preparative Regimens As can
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Conditioning for AuBMT in NHL 305 A
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Conditioning for AuBMT in NHL 307 T
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Conditioning for AuBMT in NHL 309 e
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Escalating Dose CBV in Lymphoma 311
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318 High Dose Chemotherapy with ABM
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3 CD + i— ro
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ABMT in Low Grade NHL 327 AUTOLOGOU
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ABMT in Low Grade NHL 329 ABMT Foll
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Purging and Relapse in BL 331 EX-VI
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CD "O + >- CO CU c/l TJ a. CO CI C
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CO u- 3 < H CD < £ £¡ cf 25 3 <
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Purging and Relapse in BL 337 BM af
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Detection of MRD by PCR 339 DETECTI
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Detection of MRD by PCR 341 Figure
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Detection of MRD by PCR 343 results
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346 Conditioning Regimens in Lympho
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348 Conditioning Regimens in Lympho
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Studies in Indolent Lymphoma 351 Di
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354 Detection of Disease & Purging
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ABMT as Intensification in Breast C
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ABMT as Intensification in Breast C
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AB MT as Intensification in Breast
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364 Breast Cancer: Autologous Bone
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366 Breast Cancer: Autologous Bone
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368 High Dose Chemotherapy in Breas
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370 High Dose Chemotherapy in Breas
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372 High Dose Consolidation in Brea
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378 STAMP Studies in Breast Cancer
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CO •p fi 0) •rl •P id tU o o
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STAMP Studies in Breast Cancer 383
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386 Solid Tumors I: Breast clearly
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388 Solid Tumors I: Breast cannot i
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390 Dose Intensification for the Tr
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High-Dose Intensification for Breas
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406 ABMT and Hematopoietic Recovery
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Bone Marrow Metastases in Small Cel
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422 Occult Tumor in Bone Marrow RES
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424 Occult Tumor in Bone Marrow Tab
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Breast Tumor Cell Detection 427 BRE
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Breast Tumor Cell Detection 429 Nex
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Breast Cancer 431 Discussion 2 - Se
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Breast Cancer 433 Dr. Peters: We we
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Various Treatments in Gliomas 437 H
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Various Treatments in Gliomas 439 T
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Various Treatments in Gliomas 441 T
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Various Treatments in Gliomas 443 (
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Various Treatments in Gliomas 445 G
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Various Treatments in Gliomas 447 d
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m í. o O ._• E CU c I co CJ M X
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452 ABMT in Pediatric Brain Tumors
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454 ABMT in Pediatric Brain Tumors
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Adjuvant High-Dose BCNU and BMT for
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464 Gliomas Dr. Biron: It is so dif
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466 Gliomas Dr. Biron: Among the 16
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ABMT for Germ Cell Tumors 469 HIGH-
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ABMT for Germ Cell Tumors 471 Table
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ABMT for Germ Cell Tumors 473 Group
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ABMT for Germ Cell Tumors 475 CONCL
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Massive Chemotherapy in NSGCT 477 C
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Massive Chemotherapy in NSGCT 479 N
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Massive Chemotherapy in NSGCT 481 T
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Massive Chemotherapy in NSGCT 483 T
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Massive Chemotherapy in NSGCT 485 1
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CBDCA/VP-16 in Germ-Cell Cancer 487
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494 Testicular Cancer Dr. Biron: Ho
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496 Testicular Cancer Dr. Sorzsky:
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ABMT for Advanced Melanoma 499 TREA
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ABMT for Advanced Melanoma 501 Tabl
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ABMT for Advanced Melanoma 503 Tabl
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ABMT for Advanced Melanoma 505 agen
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SESSION III - SOLID TUMORS F. OVARI
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510 HDM and ABMT in Ovarian Carcino
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SESSION III - SOLID TUMORS G. PHASE
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520 High Dose Carboplatin TREATMENT
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522 High Dose Carboplatin ABMT. In
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G.I. Tumors 525 Discussion 5 - Sess
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SESSION IV - PEDIATRIC TUMORS A. NE
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530 Treatment of Metastatic Neurobl
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BMT in Neuroblastoma 543 HIGH DOSE
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BMT in Neuroblastoma 545 lOO-i —1
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BMT in Neuroblastoma 547 100 SURVIV
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ABMT in Neuroblastoma 549 AUTOLOGOU
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O ° 4> o O ÍM -o o 00 o o in O (\
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ABMT in Neuroblastoma 553 antibodie
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•p (0 CT« O +J < 03 i) •H « c
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ABMT in Neuroblastoma 557 6. Favrot
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560 Myeloablative Treatment for Chi
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568 AutoBMT for Neuroblastoma at CH
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Neuroblastoma with Intensive Therap
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586 Neuroblastoma Dr. Philip: We us
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588 Neuroblastoma Dr. Graham-Pole:
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590 Neuroblastoma they saw relapses
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Ewing's Sarcoma Phase II Metastases
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n o + + + + + + to in •O CM CM CM
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604 ABMT in Wilms' Tumor: An EBMT S
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606 ABMT in Wilms' Tumor: An EBMT S
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Consolidation Therapy in Metastatic
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618 ABMT in Pediatric Sarcomas chem
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620 ABMT in Pediatric Sarcomas risk
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622 Sarcoma Dr. Seeger: These marro
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Effects of IL-1 on Hematopoiesis 62
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632 rhGM-CSF After Marrow Transplan
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638 IL-1 as Protection from Toxic E
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Growth Factor Therapy in Primates 6
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Differences Between Normal and Leuk
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rHuGM-CSF in Autologous Bone Marrow
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HuGM-CSF in Autologous Bone Marrow
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670 Growth Factors document all of
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Growth Factors 673 Discussion 2 - S
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SESSION VI - PERIPHERAL BLOOD STEM
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678 GM-CSF and PB Progenitor Cells
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Peripheral Blood CFU-GM and BFUe 68
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Occult Tumor in Apheresis Harvests
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Occult Tumor in Apheresis Harvests
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Stern Cell Collection and Toxicity
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704 Lymphoma and PSCT harvest. The
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706 Lymphoma and PSCT DISCUSSION Th
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708 PBSC Transplants in Solid Tumor
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714 Autologous Blood Stem Cell Tran
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716 Autologous Blood Stem Cell Tran
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Peripheral Blood Stem Cells 719 TUM
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Peripheral Blood Stem Cells 721 eig
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Myeloablative Treatments in Haemato
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734 Peripheral Blood Stem Cells Dr.
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Treatment of Cytomegalovirus Pneumo
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Treatment of Cytomegalovirus Pneumo
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Viral Infection in BMT 747 VIRAL IN
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Viral Infection in BMT 749 Table 1.
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Viral Infection in BMT 751 REFERENC
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754 IV+PO Ig in ABMT incidence of i
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756 IV+PO Ig in ABMT Table 2. Posit
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758 IV+PO Ig in ABMT Approaches for
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760 Supportive Care away with that.
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Merocyanine 540 763 MEROCYANINE 540
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Merocyanine 540 765 Table 1. Merocy
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Merocyanine 540 767 9. Kalyanaraman
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770 Purging with Aldophosphamide Ac
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Further Developments in Purging 779
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786 Further Developments in Purging
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PARMA International Protocol 793 PA
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PARMA International Protocol 795 Wk
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PARMA International Protocol 797 gr
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Double ABMT in Advanced Neuroblasto
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808 General Discussion to pathologi
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SUMMARY
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814 Autotransplants: Acute Leukemia
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576 Autotransplants: Acute Leukemia
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819 Contributors and Participants M
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821 Kenneth A. Ault, Maine Cytometr
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823 B. J. Bolwell, Cleveland Clinic
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825 Myra W. Chang, Department of He
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827 J. Crown, Memorial Sloan-Ketter
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829 Carol L. Epstein, Immunex Resea
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831 Maria Vittoria Gazzola, Unita 1
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833 Mildred S. Hanson, Tumor Immuno
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835 Herbert Kaizer, Rush-Presbyteri
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837 Eric Lepage, Institut d 1 Hemat
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839 Michel Marty, Département de C
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841 J. Myers, Memorial Sloan-Ketter
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843 C. R. Pinkerton, Department of
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845 Rein Sarai, The Johns Hopkins U
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847 J. J. Sotto, C.H.R.U. Orenoble,
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849 Guido Tricot, Department of Med
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851 J.R. Zucali, Department of Medi
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