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6. Reiffers J, Trouette R, Marit G, et al: Autologous blood stem cell transplantation for chronic granulocytic leukemia in transformation: a report of 47 cases. Br J Haematol 1991;77:339-345. 7. Sokal JE, Cox EB, Baccarani M, et al. Prognostic discrimination in "Good Risk" Chronic Granulocytic Leukemia. Blood 1984; 63:789-799. 208 SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION
AUTOGRAFTING IN CHRONIC MYELOID LEUKEMIA WITH CULTURED MARROW: RESULTS OF A PILOT STUDY. Michael J Barnett, Connie J Eaves, Gordon L Phillips, Donna E Hogge, Hans-G Klingemann, Peter M Lansdorp, Stephen H Nantel, Donna E Reece, John D Shepherd, Heather J Sutherland, Allen C Eaves. Leukemia/Bone Marrow Transplantation Program of British Columbia: Division of Hematology, British Columbia Cancer Agency, Vancouver General Hospital and the University of British Columbia, Vancouver, British Columbia, Canada. INTRODUCTION I ON In 1987, we initiated a study to evaluate the feasibility of using 10-day cultured marrow autografts to allow intensive treatment of patients with chronic myeloid leukemia (CML). 1 The rationale for this approach is based on evidence that leukemic stem cells (operationally defined as Philadelphia chromosome [ph']-positive long-term culture initiating cells [LTC-IC]) are, on average, present in CML marrow at levels 10-fold lower than their normal counterparts and can be selectively "purged" (by a factor of 30-fold) following incubation for 10 days in LTC. 2 " 4 Patients were selected for this pilot study on the basis of a previous laboratory assessment of the frequencies of normal and leukemic LTC-IC remaining in their marrow at the end of 10 days of incubation in vitro under LTC conditions. The purpose of this was to establish whether a subsequently harvested and similarly treated autograft would be likely to have sufficient normal stem cells to allow engraftment and no detectable leukemic stem cells. 1 METHODS Between April 1987 and February 1992,88 candidate patients (aged < 60 years, in morphological chronic phase of CML and ineligible for allogeneic bone marrow transplantation [BMT]) had their marrow assessed after 10 days of LTC for normal and leukemic LTC-IC numbers using previously described procedures. 1,5 In 36 patients (41%), normal LTC-IC in these cultured samples were present at > 2% of normal marrow values and leukemic LTC-IC were not detectable. Only patients meeting these criteria were considered eligible for autografting. Twenty-two patients (aged 22 to 59 years, median 43), 15 in first chronic phase (Group 1) and 7 in accelerated or > first chronic phase (Group 2), were autografted with 10-day cultured marrow after either a total body irradiationbased (3 patients) or a busulfan-based (19 patients) regimen. The methods employed for manipulating the autograft were as previously described. 1 Briefly, ~2 x 10 10 nucleated cells were set up in culture, and 10 days later all cells present (range 1.0 to 4.4 x 108/kg, median 1.7) were collected and infused. SIXTH INTERNATIONAL SYMPOSIUM ON AUTOLOGOUS BONE MARROW TRANSPLANTATION 209
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Autologous Bone Marrow Transplantat
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CONTENTS nviAum TMLHTA'I OTT! 7 A l
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AUTOLOGOUS BONE MARROW TRANSPLANTAT
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TREATMENT OF NONSMALL CELL LUNG CAN
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SUMMARY OF THE NON HODGKIN LYMPHOMA
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Session I: Leukemia
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TRIAL PROGRESS The trial opened in
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Table 1. Achievement of Second Remi
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ALLOGENEIC VERSUS AUTOLOGOUS BONE M
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pts). The other 56 pts are too earl
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Figure 1 EORTC-GIMEMA AML 8 A EORTC
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PATIENTS AND METHODS Patients The B
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Thus, as the results of some ongoin
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COMPARISON OF INTENSIVE CONSOLIDATI
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over, 13 pts who had received ICC1
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Session II: Future Directions
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in a previous report 3 . Analysis a
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Engraftment of granulocyte, monocyt
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0.2 - 0.1 - ABMT with mAb purging f
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ENHANCED REGENERATION OF NATURAL KI
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RESULTS The in vivo immune effects
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16. Rizzoli V, Mangoni L, Carlo-Ste
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hydroperoxycyclophosphamide (4HC)-t
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survival in patients undergoing ABM
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IMMUNOTHERAPY OF AML AFTER ABMT - S
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Otherwise toxicity was mild to mode
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Therapy. Amsterdam Elsevier 1987;89
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200 IL6 in serum 44 SIXTH INTERNATI
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sodes), fewer days of i.v. antibiot
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Session III: Myeloma
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trary, in case of adequate collecti
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tion is considered, and all the mor
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Table 3: Cost effectiveness of high
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Session W: Lymphoma
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METHODS Selection of patients and t
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marrow treatment. Am J Med 85:829,1
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HIGH DOSE THERAPY WITH HEMATOPOIETI
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in TC 19 medium (Flobio), with an h
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progression for a long time after A
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Table 2. STATUS AT GRAFT Remission
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IL Figura 3 70 SIXTH INTERNATIONAL
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( 5 ) lowed by ABMT than refractory
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74 Figure 4 Low grade lymphoma - pr
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(range 15-55); 68 males and 32 fema
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our experience, this has a seven-ye
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30. Colombat P, Gorin NC, Lemonnier
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82 OVERALL SURUIWL from ABUT (accor
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PROGNOSTIC FACTORS IN ADVANCED STAG
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REFERENCES 1. Chopra R, Mc Millan A
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lished data to attempt to assess th
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1992;10:175-7. 3. McMillan A, Golds
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B. DAILY DAY AGENT DOSE -7 -6 -5 -4
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cohort with HR treated with BEC-2 i
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p R 0 P O R T I 0 N 1 0.9 0.8 0.7 0
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TABLE 3. TOXICITY BEC TAVe TMJ as 2
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ies. 10 Longer blood half-lives hav
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agents have been developed cautious
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Table 1. Radioisotopes for RIT. Pur
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The treatment criterion in this stu
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more than 80% of the cases. Patient
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Disease Free Survival 800 Time •
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Session VI: Breast Cancer
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achieved a complete remission survi
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acil, vincristine, prednisone (CMFV
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t: 3 en a in S « J •S •> c ai
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LONG TERM FOLLOW UP OF POOR PROGNOS
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tors both for progression-free surv
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222 INDUCTION PHASE ESTROGEN RECEPT
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THE PHARMACOLOGY OF INTENSIVE CYCLO
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PK VARIABILITY OF CPA/CDDP/BCNU Whe
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5. Groshow LB, Piantadosi S, Santos
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- Tn'üTiifi'.m'jii.'yjKJiHtyiwiT T
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normal CD34+ progenitor cells
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sequence analysis of the human haem
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Bielefeld, FRG) or control medium w
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3. Koeffler HP, and Golde DW: Chron
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ply infected with supernatants from
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controls must be carefully matched
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Fig. IB: GPI isozyme analysis of 2
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PROCESSING OF STEM CELLS FOR TRANSP
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in progress using marker genes to l
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Table 1. Factors Affecting Quality
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Figure 2 .2 A Refractory/Relapsed L
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HIGH DOSE CHEMOTHERAPY IN GERM CELL
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carboplatin and etoposide with auto
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HIGH DOSE THERAPY IN GERM CELL TUMO
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Confusing data come out from early
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Session Mill: Lung Cancer
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Of the 14 limited stage patients in
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Page 200 and 201: Cellules. Bull Cancer 1987;74:587-5
Page 202 and 203: 30 36 42 48 54 60 66 72 78 84 12 18
Page 204 and 205: Table 2: Toxicity of CBP Regimen fo
Page 206 and 207: TREATMENT OF NONSMALL CELL LUNG CAN
Page 208 and 209: Table 1. Combination Chemotherapy R
Page 210 and 211: Table 6. Hematological Data of the
Page 212 and 213: ence in survival among the three hi
Page 215: Session IX: Ovarian Cancer
Page 218 and 219: lymph node involvement or parenchym
Page 220 and 221: higher frequencies of neurotoxicity
Page 222 and 223: 12. Ovarian Cancer Meta-Analysis Pr
Page 224 and 225: Table 2. Randomized Trials Employin
Page 226 and 227: BONE MARROW TRANSPLANTATION FOR OVA
Page 228 and 229: 1). Data from the survey was combin
Page 230 and 231: carboplatinum and ifosfamide. The s
Page 233: Session X: Sarcoma
Page 236 and 237: ated doses in a recent Pediatric On
Page 238 and 239: cytokines to reduce hospitalization
Page 240 and 241: TABLE 2 Dose Escalation Schedule Do
Page 243 and 244: CHRONIC MYELOGENOUS LEUKEMIA WITH B
Page 245: DISCUSSION In this study, the use o
Page 249 and 250: Table 1 Remission Deaths Graft Hema
Page 251 and 252: 16 (800 mg/m2 per day for two conse
Page 253: Session XII: CNS
Page 256 and 257: 1.2 Description of the study The tr
Page 258 and 259: 3. Conclusion In conclusion, treatm
Page 260 and 261: 3. Conclusion Hematological toxicit
Page 263: Session XIII: Peripheral Stem Cells
Page 266 and 267: Crouse, 1992). In the present repor
Page 268 and 269: with no evidence of systemic diseas
Page 270 and 271: Administration of rhSCF at doses of
Page 272 and 273: In summary, the ligand for c-kit ha
Page 274 and 275: AUTOGRAFTING WITH G-CSF-MOBILIZED B
Page 276 and 277: cells and CD34+ cells observed in t
Page 278 and 279: 6. Brugger W, Bross K, Frisch J, et
Page 280 and 281: 100 -l Collection Efficiency Figure
Page 282 and 283: MATERIALS AND METHODS PATIENTS. Pat
Page 284 and 285: None of the patients included in ar
Page 286 and 287: 9. Aurer I, Ribas A, Gale RP. What
Page 288 and 289: 246 o 0.6 b 0.1 B1 Figure 2 p = 0.0
Page 291 and 292: AUTOLOGOUS BONE MARROW TRANSPLANTAT
Page 293 and 294: SUMMARY OF THE NON HODGKIN LYMPHOMA
Page 295 and 296: SUMMARY: AUTOLOGOUS MARROW TRANSPLA
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mor. The obverse of this coin is po
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treated at Memorial Hospital in New
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Contributors and Participants Tause
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Leonard Kalman, Hematology/Oncology
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D.R. Sutherland, Oncology Research,
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