Monoclonal antibody-purged autologous bone marrow transplantation in adults with acute lymphoblastic leukemia at high risk of relapse

R. J. Soiffer, D. C. Roy, R. Gonin, C. Murray, K. C. Anderson, A. S. Freedman, S. N. Rabinowe, Michael Robertson, N. Spector, K. Pesek, P. Mauch, L. M. Nadler, J. Ritz

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Abstract

The prognosis for adults with B lineage ALL who have relapsed after an initial remission is poor. High-dose chemoradiotherapy followed by autologous BMT can induce prolonged clinical remissions in some children with recurrent ALL. In this study, we evaluated the efficacy of autologous BMT in adults. Autologous marrow was treated in vitro with J5 and J2 monoclonal antibodies (CD10/CD9) plus rabbit complement to purge residual ALL cells. Twenty-two adults with B lineage ALL were treated with high-dose chemoradiotherapy followed by infusion of J2/J5 purged autologous BM. The median age was 28 years (range 18-54 years). Twenty-one of 22 patients had experienced at least one relapse prior to BMT. All patients achieved complete hematologic engraftment. Disease-free survival (DFS) in this cohort of patients was 20%, with all survivors alive and free of disease between 2.5 and 7.5 years post-BMT. Age at the time of BMT was an important prognostic factor, with patients <28 years old faring much better than older individuals (DFS, 45% vs 0%, p = 0.01). Our experience suggests that high-dose chemoradiotherapy followed by infusion of J2/J5 purged autologous marrow is as efficacious in young adults as it is in children and is a reasonable alternative for patients who lack HLA-matched donors. Results in older adults are poor, however, and demonstrate the need for more effective transplant strategies in these individuals.

Original languageEnglish (US)
Pages (from-to)243-251
Number of pages9
JournalBone Marrow Transplantation
Volume12
Issue number3
StatePublished - 1993
Externally publishedYes

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Autologous Transplantation
Bone Marrow Transplantation
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Monoclonal Antibodies
Chemoradiotherapy
Recurrence
Disease-Free Survival
Bone Marrow
Survivors
Young Adult
Tissue Donors
Rabbits
Transplants

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Soiffer, R. J., Roy, D. C., Gonin, R., Murray, C., Anderson, K. C., Freedman, A. S., ... Ritz, J. (1993). Monoclonal antibody-purged autologous bone marrow transplantation in adults with acute lymphoblastic leukemia at high risk of relapse. Bone Marrow Transplantation, 12(3), 243-251.

Monoclonal antibody-purged autologous bone marrow transplantation in adults with acute lymphoblastic leukemia at high risk of relapse. / Soiffer, R. J.; Roy, D. C.; Gonin, R.; Murray, C.; Anderson, K. C.; Freedman, A. S.; Rabinowe, S. N.; Robertson, Michael; Spector, N.; Pesek, K.; Mauch, P.; Nadler, L. M.; Ritz, J.

In: Bone Marrow Transplantation, Vol. 12, No. 3, 1993, p. 243-251.

Research output: Contribution to journalArticle

Soiffer, RJ, Roy, DC, Gonin, R, Murray, C, Anderson, KC, Freedman, AS, Rabinowe, SN, Robertson, M, Spector, N, Pesek, K, Mauch, P, Nadler, LM & Ritz, J 1993, 'Monoclonal antibody-purged autologous bone marrow transplantation in adults with acute lymphoblastic leukemia at high risk of relapse', Bone Marrow Transplantation, vol. 12, no. 3, pp. 243-251.
Soiffer, R. J. ; Roy, D. C. ; Gonin, R. ; Murray, C. ; Anderson, K. C. ; Freedman, A. S. ; Rabinowe, S. N. ; Robertson, Michael ; Spector, N. ; Pesek, K. ; Mauch, P. ; Nadler, L. M. ; Ritz, J. / Monoclonal antibody-purged autologous bone marrow transplantation in adults with acute lymphoblastic leukemia at high risk of relapse. In: Bone Marrow Transplantation. 1993 ; Vol. 12, No. 3. pp. 243-251.
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abstract = "The prognosis for adults with B lineage ALL who have relapsed after an initial remission is poor. High-dose chemoradiotherapy followed by autologous BMT can induce prolonged clinical remissions in some children with recurrent ALL. In this study, we evaluated the efficacy of autologous BMT in adults. Autologous marrow was treated in vitro with J5 and J2 monoclonal antibodies (CD10/CD9) plus rabbit complement to purge residual ALL cells. Twenty-two adults with B lineage ALL were treated with high-dose chemoradiotherapy followed by infusion of J2/J5 purged autologous BM. The median age was 28 years (range 18-54 years). Twenty-one of 22 patients had experienced at least one relapse prior to BMT. All patients achieved complete hematologic engraftment. Disease-free survival (DFS) in this cohort of patients was 20{\%}, with all survivors alive and free of disease between 2.5 and 7.5 years post-BMT. Age at the time of BMT was an important prognostic factor, with patients <28 years old faring much better than older individuals (DFS, 45{\%} vs 0{\%}, p = 0.01). Our experience suggests that high-dose chemoradiotherapy followed by infusion of J2/J5 purged autologous marrow is as efficacious in young adults as it is in children and is a reasonable alternative for patients who lack HLA-matched donors. Results in older adults are poor, however, and demonstrate the need for more effective transplant strategies in these individuals.",
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AB - The prognosis for adults with B lineage ALL who have relapsed after an initial remission is poor. High-dose chemoradiotherapy followed by autologous BMT can induce prolonged clinical remissions in some children with recurrent ALL. In this study, we evaluated the efficacy of autologous BMT in adults. Autologous marrow was treated in vitro with J5 and J2 monoclonal antibodies (CD10/CD9) plus rabbit complement to purge residual ALL cells. Twenty-two adults with B lineage ALL were treated with high-dose chemoradiotherapy followed by infusion of J2/J5 purged autologous BM. The median age was 28 years (range 18-54 years). Twenty-one of 22 patients had experienced at least one relapse prior to BMT. All patients achieved complete hematologic engraftment. Disease-free survival (DFS) in this cohort of patients was 20%, with all survivors alive and free of disease between 2.5 and 7.5 years post-BMT. Age at the time of BMT was an important prognostic factor, with patients <28 years old faring much better than older individuals (DFS, 45% vs 0%, p = 0.01). Our experience suggests that high-dose chemoradiotherapy followed by infusion of J2/J5 purged autologous marrow is as efficacious in young adults as it is in children and is a reasonable alternative for patients who lack HLA-matched donors. Results in older adults are poor, however, and demonstrate the need for more effective transplant strategies in these individuals.

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