Chemotherapy and donor peripheral blood progenitor cells for acute leukemia in early relapse after allogeneic bone marrow transplantation

E. P. Alessandrino, P. Bernasconi, D. Caldera, A. Colombo, L. Malcovati, G. Martinelli, M. Bonfichi, G. Pagnucco, L. Salvaneschi, C. Bernasconi

Research output: Contribution to journalArticle

Abstract

Ten patients with acute leukemia (AL) in early relapse after allo-BMT were treated with a modified MEC (mitoxantrone, etoposide and Ara-C) regimen followed by donor PBPC collected after mobilization with GCSF. Seven patients achieved CR or had normal hemopoietic reconstitution: two had an early relapse at days +53 and +48, two patients died from acute GVHD at days +31 and +96, one died of interstitial pneumonia at day +55, and two patients experienced long-term survival. One patient with refractory disease and nodal involvement who did not respond to the first BMT had overt expansion of the leukemia at day +36; one patient with Ph+ ALL and one with ANLL evolving from MDS, both with skin involvement, had blast cells in peripheral blood at day +27 and +26, respectively. Transient cytopenia occurred in all patients; a normal granulocyte and platelet count was achieved within 3 weeks in all patients but one; acute GVHD occurred in six patients, and four had chronic GVHD. This approach is feasible in patients in early relapse after allo-BMT. It assists prompt re-establishment of normal donor hematopoiesis avoiding the prolonged cytopenia observed after donor lymphocyte infusion in AL patients relapsed after allo-BMT.

Original languageEnglish
Pages (from-to)607-612
Number of pages6
JournalBone Marrow Transplantation
Volume23
Issue number6
Publication statusPublished - 1999

Keywords

  • Acute leukemia
  • Allogeneic bone marrow transplantation
  • Graft-versus-leukemia
  • PBPC
  • Relapse after allo-BMT

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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