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Acute Myeloid Leukaemia

Partially mismatched related donor bone marrow transplantation as salvage for patients with AML who failed autologous stem cell transplant

Bone Marrow Transplantation volume 28, pages 1031–1036 (2001)Cite this article

An Erratum to this article was published on 05 July 2002

Abstract

Treatment options for patients who relapse are limited and the outcome is dismal. Between August 1993 and January 1999, 17 patients, median age 26 (4–44) years, underwent T cell depleted bone marrow transplant from partially mismatched related donors (PMRD), as a salvage for AML relapsing after an autograft. The median time from auto-transplant to relapse was 7 months (1.5–24) and the interval between transplants was 10 months (3–30). All patients had active leukemia at time of transplant. Donors were siblings (n = 8), parents (n = 2), daughters (n = 4) and others (n = 3), and 82% were ⩾2 major HLA antigen mismatched with the recipient. The conditioning therapy included total body irradiation in 14 patients and was busulfan-based in three. Graft-versus-host disease (GVHD) prophylaxis consisted of partial T cell depletion along with post-transplant immunosuppression. Median day to engraftment was 16 days (12–20). Acute GVHD was seen in six patients, and chronic GVHD in four of 13 surviving beyond 100 days. Ten patients died of non-relapse causes, at 1–588 (median 77) days. Two patients relapsed at 3 and 4 months. Five patients (29%) are surviving leukemia-free 42–84 months post transplant (median 68 months). A short interval between transplants was predictive of early relapse but not mortality. Age <18 and <2 organ toxicities were marginally predictive of better survival. We conclude that BMT from PMRD is a reasonable option for patients with refractory AML post autograft.

Bone Marrow Transplantation (2001) 28, 1031–1036.

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References

  1. Zittoun RA, Mandelli F, Willemze R et al. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia New Engl J Med 1995 332: 217–223

    Article  CAS  PubMed  Google Scholar 

  2. Miggiano MC, Gherlinzoni F, Rosti G et al. Autologous bone marrow transplantation in late first complete remission improves outcome in acute myelogenous leukemia Leukemia 1996 10: 402–409

    CAS  PubMed  Google Scholar 

  3. Cassileth PA, Andersen J, Lazarus HM et al. Autologous bone marrow transplant in acute myeloid leukemia in first remission J Clin Oncol 1993 11: 314–319

    Article  CAS  PubMed  Google Scholar 

  4. Schiller GJ, Nimer SD, Territo MC et al. Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission J Clin Oncol 1992 10: 41–46

    Article  CAS  PubMed  Google Scholar 

  5. Reiffers J, Gaspard MH, Maraninchi D et al. Comparison of allogeneic or autologous bone marrow transplantation and chemotherapy in patients with acute myeloid leukaemia in first remission: a prospective controlled trial Br J Haematol 1989 72: 57–63

    Article  CAS  PubMed  Google Scholar 

  6. Keating MJ, Kantarjian H, Smith-TL et al. Response to salvage therapy and survival after relapse in acute myelogenous leukemia J Clin Oncol 1989 7: 1071–1080

    Article  CAS  PubMed  Google Scholar 

  7. De la Rubia J, Sanz GF, Martin G et al. Autologous bone marrow transplantation for patients with acute myeloblastic leukemia in relapse after autologous blood stem cell transplantation Bone Marrow Transplant 1996 18: 1167–1173

    CAS  PubMed  Google Scholar 

  8. Mehta J, Powles R, Treleaven J et al. Outcome of acute leukemia relapsing after bone marrow transplantation: utility of second transplants and adoptive immunotherapy Bone Marrow Transplant 1997 19: 709–719

    Article  CAS  PubMed  Google Scholar 

  9. Ringden O, Labopin M, Gluckman E et al. Donor search or autografting in patients with acute leukemia who lack an HLA-identical sibling? A matched pair analysis Bone Marrow Transplant 1997 19: 963–968

    Article  CAS  PubMed  Google Scholar 

  10. Godder K, Pati AR, Abhyankar S et al. Partially mismatched related donor transplants as salvage therapy for patients with refractory leukemia who relapse post-BMT Bone Marrow Transplant 1996 17: 49–53

    CAS  PubMed  Google Scholar 

  11. Henslee-Downey PJ, Abhyankar SH, Parrish RS et al. Use of partially mismatched related donors extends access to allogeneic marrow transplant Blood 1997 89: 3864–3872

    CAS  PubMed  Google Scholar 

  12. Henslee-Downey PJ, Lee CG, LJ Hazlett et al. Rare failure to engraft following haploidentical T-cell depleted marrow transplantation using enhanced host immunoablation and OKT3 graft purging Exp Hematol 1997 25: Abstr. 183

    Google Scholar 

  13. Godder KT, Hazlett LJ, Abhyankar SH et al. Partially mismatched related donors allow for early allogeneic transplant intervention and improved disease free survival in young patients with poor prognosis acute leukemia J Clin Oncol 2000 18: 1856–1866

    Article  CAS  PubMed  Google Scholar 

  14. Lee C, Brouillette M, Lamb L et al. Use of a closed system for V αβ-positive T-cell depletion of marrow for use in partially mismatched related donor transplantation Prog Clin Biol Res 1994 389: 523–532

    CAS  PubMed  Google Scholar 

  15. Lee C, Brouillette M, Hazlett L et al. Comparison of engraftment and acute GvHD following transplantation of partially mismatched grafts T cell depleted with OKT3 or T10B9 monoclonal antibody J Hematother 1997 4: 395

    Google Scholar 

  16. Tsai T, Goodman S, Saez R et al. Allogeneic bone marrow transplantation in patients who relapse after autologous transplantation Bone Marrow Transplant 1997 20: 859–863

    Article  CAS  PubMed  Google Scholar 

  17. Pati AR, Godder K, Parrish R et al. Pre-emptive therapy with donor leukocyte infusions to prevent relapse following partially mismatched related donor bone marrow transplantation Blood 1996 88: 259a

    Google Scholar 

  18. Radich JP, Sanders JE, Buckner CD et al. Second allogeneic marrow transplantation for patients with recurrent leukemia after initial transplant with total-body irradiation-containing regimens J Clin Oncol 1993 11: 304–313

    Article  CAS  PubMed  Google Scholar 

  19. Barrett AJ, Locatelli F, Treleaven JG et al. Second transplants for leukemic relapse after bone marrow transplantation: high early mortality but favorable effect of chronic GVHD on continued remission Br J Haematol 1991 79: 567–574

    Article  CAS  PubMed  Google Scholar 

  20. Mrsic M, Horowitz MM, Atkinson K et al. Second HLA-identical sibling transplants for leukemia recurrence Bone Marrow Transplant 1992 9: 269–275

    CAS  PubMed  Google Scholar 

  21. Wagner JE, Vogelsang GB, Zehanbaur BA et al. Relapse of leukemia after bone marrow transplantation: effect of second myeloablative therapy Bone Marrow Transplant 1992 9: 205–209

    CAS  PubMed  Google Scholar 

  22. Lamb LS Jr, Gee AP, Henslee-Downey PJ et al. Phenotypic and functional reconstitution of peripheral blood lymphocytes following T cell-depleted bone marrow transplantation from partially mismatched related donors Bone Marrow Transplant 1998 21: 461–471

    Article  PubMed  Google Scholar 

  23. Small TN, Papadopoulos EB, Boulad F et al. Comparison of immune reconstitution after related and related T-cell depleted bone marrow transplantation: effect of patient age and donor leukocyte infusion Blood 1999 93: 467–480

    CAS  PubMed  Google Scholar 

  24. Radich JP, Gooley T, Sanders J et al. Second allogeneic transplantation after failure of first autologous transplantation Biol Blood Marrow Transplant 2000 6: 272–279

    Article  CAS  PubMed  Google Scholar 

  25. Bosi A, Bacci S, Miniero R et al. Second allogeneic bone marrow transplantation in acute leukemia: a multicenter study from the Gruppo Italiano Trapianto Di Modollo Osseo (GITMO) Leukemia 1997 11: 420–424

    Article  CAS  PubMed  Google Scholar 

  26. Chiang KY, Weisdorf DJ, Davies SM et al. Outcome of second bone marrow transplantation following a uniform conditioning regimen as therapy for malignant relapse Bone Marrow Transplant 1996 17: 39–42

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Transplantation Medicine, South Carolina Cancer Center, Columbia, SC, USA

    KT Godder, J Metha, KY Chiang, S Adams, F van Rhee, S Singhal, K Higgins-Smith, W O'Neal, S DeRienzo & JP Henslee-Downey

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  1. KT Godder
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  2. J Metha
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Godder, K., Metha, J., Chiang, K. et al. Partially mismatched related donor bone marrow transplantation as salvage for patients with AML who failed autologous stem cell transplant. Bone Marrow Transplant 28, 1031–1036 (2001). https://doi.org/10.1038/sj.bmt.1703279

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