Double reinforcement with fludarabine/high-dose cytarabine enhances the impact of autologous stem cell transplantation in acute myeloid leukemia patients.

Abstract:

:Reinforced chemotherapy based on a double high-dose consolidation regimen could be a different way to enhance in vivo purging prior to autologous stem cell transplantation (auto-SCT) in acute myeloid leukemia (AML). We investigated the impact on outcome of auto-SCT after two different strategies of early intensification performed after an identical induction regimen in adult patients with AML. Between January 1993 and December 1998, 140 consecutive AML patients were enrolled in a program consisting of an identical anthracycline-based induction (ICE) and two different consolidation regimens: one cycle, cytarabine-based (single-NOVIA: 91 patients); two cycles, fludarabine-based (double-FLAN: 49 patients). Seventy out of 91 patients received single-NOVIA consolidation: 60 underwent a transplantation procedure (allogeneic bone marrow transplantation (allo-BMT):16 patients; auto-SCT: 44). Thirty-five out of 49 patients received double-FLAN consolidation: 31 underwent a transplantation procedure (allo-BMT: 10; auto-SCT: 21). The double consolidation regimen was well-tolerated with only minor side-effects. Median follow-up observation time for surviving patients was 38 months (range, 17-71) for the double-FLAN consolidation group and 70 months (range: 48-93) for the single-NOVIA consolidation group. Among the patients who received auto-SCT, the double consolidation strategy produced a superior disease-free survival curve at 36 months (78.6% (95%CI: 59.4-97.8) vs 47.7% (95%CI: 33-62.4)) compared with the single-NOVIA group. This difference was confirmed when the patients were analyzed for intention to treat (P = 0.04). In addition, the double-FLAN consolidation group showed a superior overall survival and lower relapse rate (P = 0.02). We conclude that the double-FLAN reinforcement strategy is safe and enhances the clinical impact of auto-SCT for AML patients in first complete remission. It may provide specific clinical benefit for patients undergoing auto-SCT.

journal_name

Bone Marrow Transplant

authors

Visani G,Lemoli RM,Isidori A,Piccaluga PP,Martinelli G,Malagola M,Gugliotta L,Bonini A,Bonifazi F,Motta MR,Rizzi S,Castellani S,Tura S

doi

10.1038/sj.bmt.1703003

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

829-35

issue

8

eissn

0268-3369

issn

1476-5365

journal_volume

27

pub_type

临床试验,杂志文章
  • Hematopoietic stem-cell transplantation in children with refractory acute myeloid leukemia.

    abstract::Allogeneic hematopoietic stem cell transplantation (HSCT) can be used to treat children with refractory acute myeloid leukemia (AML). This retrospective analysis aimed to describe the outcomes and risk factors in such children. Data were collected through the nation-wide registry program in Japan. A total of 417 AML (...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/s41409-019-0461-0

    authors: Okamoto Y,Kudo K,Tabuchi K,Tomizawa D,Taga T,Goto H,Yabe H,Nakazawa Y,Koh K,Ikegame K,Yoshida N,Uchida N,Watanabe K,Koga Y,Inoue M,Kato K,Atsuta Y,Ishida H

    更新日期:2019-09-01 00:00:00

  • Mismatched bone marrow transplantation for Omenn syndrome: a variant of severe combined immunodeficiency.

    abstract::Omenn syndrome is a variant of SCID, inherited as an autosomal recessive disorder, and characterized by severe eczematoid dermatitis, eosinophilia, elevated serum IgE and a distinctive histology in enlarged lymph nodes. The etiology of Omenn syndrome is unknown, however, unlike other forms of SCID; patients with Omenn...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Loechelt BJ,Shapiro RS,Jyonouchi H,Filipovich AH

    更新日期:1995-09-01 00:00:00

  • Allogeneic transplantation of purified CD34+ cells from peripheral blood: Spanish experience of 62 cases. Spanish Group of allo-PBT.

    abstract::This report summarizes the Spanish experience of 62 cases of allogeneic transplantation of purified CD34+ cells from peripheral blood. HLA-identical sibling donors received G-CSF. After leukapheresis, peripheral blood progenitor cells were purified using one of two methods: Ceprate (n = 38), or Isolex 300 (n = 24). Si...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Urbano-Ispizua A,Solano C,Brunet S,de la Rubia J,Odriozola J,Zuazu J,Figuera A,Caballero D,Martínez C,García J,Sanz G,Torrabadella M,Alegre A,Pérez-Oteiza J,Jurado M,Oyonarte S,Sierra J,García-Conde J,Rozman C

    更新日期:1998-06-01 00:00:00

  • Immunological questions on hematopoietic stem cell transplantation for multiple sclerosis.

    abstract::Multiple sclerosis (MS) is considered an inflammatory autoimmune disorder. Approved immunotherapies are only moderately effective in reducing disease exacerbations and brain inflammation in a subset of patients. Autologous hematopoietic stem cell transplantation (HSCT) has emerged in recent years as the first opportun...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,评审

    doi:10.1038/sj.bmt.1704096

    authors: Muraro PA,Martin R

    更新日期:2003-08-01 00:00:00

  • High dose chemotherapy with ABMT in soft tissue sarcomas: a report of 22 cases.

    abstract::Twenty-two patients with locally advanced or metastatic soft tissue sarcomas received high dose chemotherapy with autologous bone marrow graft. Eleven patients receiving melphalan also received fractionated total body irradiation. Six patients (four in CR and two in PR) were intensified after first line therapy. Thirt...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Dumontet C,Biron P,Bouffet E,Blay JY,Meckenstock R,Chauvin F,Philip I,Clavel M,Brunat-Mentigny M,Philip T

    更新日期:1992-11-01 00:00:00

  • The clinical value of biomarkers in respiratory complications in hematopoietic SCT.

    abstract::To determine the role of biomarkers in the clinical management of respiratory complications (RC) in hematopoietic stem cell transplantation (HSCT) recipients, we have prospectively evaluated a cohort of 175 patients followed-up for 1 year after HSCT. To avoid misinterpretation, we have excluded both unidentified respi...

    journal_title:Bone marrow transplantation

    pub_type: 临床试验,杂志文章

    doi:10.1038/bmt.2016.280

    authors: Lucena CM,Rovira M,Gabarrús A,Filella X,Martínez C,Domingo R,Torres A,Agustí C

    更新日期:2017-03-01 00:00:00

  • Allogeneic peripheral blood stem cell transplantation using a fludarabine-based low intensity conditioning regimen for malignant lymphoma.

    abstract::Relapse is a serious complication following high-dose therapy and autologous bone marrow transplantation (ABMT) for malignant lymphoma (ML). Allogeneic transplantation (alloSCT) is a therapeutic option. However, it is associated with a high incidence of transplant-related organ toxicity and mortality. We recently repo...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1702392

    authors: Nagler A,Slavin S,Varadi G,Naparstek E,Samuel S,Or R

    更新日期:2000-05-01 00:00:00

  • Value of surveillance blood culture for early diagnosis of occult bacteremia in patients on corticosteroid therapy following allogeneic hematopoietic stem cell transplantation.

    abstract::Bloodstream infection (BSI) is a significant complication following allogeneic hematopoietic stem cell transplantation (allo-SCT). Corticosteroids mask inflammatory responses, delaying the initiation of antibiotics. We reviewed medical records of 69 allo-SCT patients who had been on >0.5 mg/kg prednisolone to investig...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704830

    authors: Chizuka A,Kami M,Kanda Y,Murashige N,Kishi Y,Hamaki T,Kim SW,Hori A,Kojima R,Mori SI,Tanosaki R,Gomi H,Takaue Y

    更新日期:2005-03-01 00:00:00

  • Value of cytomegalovirus detection by PCR in bronchoalveolar lavage routinely performed in asymptomatic bone marrow recipients.

    abstract::In order to compare PCR with rapid virus culture for the early detection of CMV in bronchoalveolar lavage (BAL) after bone marrow transplantation, 26 asymptomatic patients were routinely evaluated for the presence of CMV on day 35 using these two techniques. Concurrent blood samples were also analyzed in all cases. CM...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1700941

    authors: Fajac A,Stéphan F,Ibrahim A,Gautier E,Bernaudin JF,Pico JL

    更新日期:1997-10-01 00:00:00

  • Evaluation of pretransplant influenza vaccination in hematopoietic SCT: a randomized prospective study.

    abstract::Pretransplant influenza vaccination of the donor or allogeneic hematopoietic SCT (HSCT) candidate was evaluated in a randomized study. One hundred and twenty-two HSCT recipients and their donors were assigned to three randomization groups: no pretransplant vaccination (n=38), donor pretransplant vaccination (n=44) or ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1038/bmt.2015.47

    authors: Ambati A,Boas LS,Ljungman P,Testa L,de Oliveira JF,Aoun M,Colturato V,Maeurer M,Machado CM

    更新日期:2015-06-01 00:00:00

  • Specific depletion of alloreactivity against haplotype mismatched related individuals by a recombinant immunotoxin: a new approach to graft-versus-host disease prophylaxis in haploidentical bone marrow transplantation.

    abstract::Haploidentical bone marrow transplantation (BMT) is associated with a high risk of severe graft-versus-host disease (GVHD). While pan-T cell depletion of the graft is the most effective means of preventing severe GVHD, it is associated with delayed recovery of T cell function leading to fatal infections. We used two r...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Mavroudis DA,Jiang YZ,Hensel N,Lewalle P,Couriel D,Kreitman RJ,Pastan I,Barrett AJ

    更新日期:1996-05-01 00:00:00

  • Tandem autologous-reduced intensity allogeneic stem cell transplantation in high-risk relapsed Hodgkin lymphoma: a retrospective study of the Lymphoma Working Party-EBMT.

    abstract::Autologous hematopoietic stem cell transplantation (ASCT) is curative for a proportion of patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL). However, there is a small group of patients with high-risk of relapse after ASCT that might benefit from other approaches. We conducted a retrospective analysis on 12...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/s41409-020-01075-y

    authors: Bento L,Boumendil A,Finel H,Khvedelidze I,Blaise D,Fegueux N,Castagna L,Forcade E,Chevallier P,Mordini N,Brice P,Deconinck E,Gramatzki M,Corradini P,Hunault M,Musso M,Tsoulkani A,Caballero D,Nati S,Montoto S,Sured

    更新日期:2020-10-12 00:00:00

  • Incidence and outcome of Clostridium difficile infection following autologous peripheral blood stem cell transplantation.

    abstract::A retrospective evaluation of 200 consecutive recipients of autologous peripheral blood stem cell transplantation (PBSCT) was conducted to ascertain the incidence and outcome of infection with Clostridium difficile. The diagnosis was confirmed in 14 patients with diarrhea (15 episodes) at a median of 33 days after ste...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701773

    authors: Bilgrami S,Feingold JM,Dorsky D,Edwards RL,Bona RD,Khan AM,Rodriguez-Pinero F,Clive J,Tutschka PJ

    更新日期:1999-05-01 00:00:00

  • Extent of variability inherent in measurements of CD34-positive cells in different human haemopoietic tissues.

    abstract::Estimation of CD34 expression is widely used to detect and quantify progenitor cells in haemopoietic tissues used as stem cell sources for transplantation. Mouse monoclonal antibodies to CD34 recognise different epitopes of the mucin-like sialoglycoprotein. These epitopes can be grouped into three classes by their dif...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Titley I,Healy LE,Scott M,Amos TA,Gordon MY

    更新日期:1995-10-01 00:00:00

  • The importance of CD34+/CD33- cells in platelet engraftment after intensive therapy for cancer patients given peripheral blood stem cell rescue.

    abstract::The study was designed to determine whether the number of CD34+/CD33- cells given at autologous peripheral blood stem cell (PBSC) rescue after intensive therapy for cancer was a better predictor of platelet engraftment than the total number of CD34+ cells infused. Comparison between the total number of CD34+ cells/kg ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701368

    authors: Millar BC,Millar JL,Shepherd V,Blackwell P,Porter H,Cunningham D,Judson I,Treleaven J,Powles RL,Catovsky D

    更新日期:1998-09-01 00:00:00

  • Unsuccessful CTL transfusion in a case of post-BMT Epstein-Barr virus-associated lymphoproliferative disorder (EBV-LPD).

    abstract::A patient with AML (FAB M4Eo) developed EBV-LPD 1.5 months after allogeneic BMT from his one locus-mismatched mother, the diagnosis being confirmed on day +82. Attempts to eradicate the monoclonally proliferating LPD using chemotherapy (VP16/dexamethasone) followed by two doses of EBV-specific CTL and one dose of unst...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1700883

    authors: Imashuku S,Goto T,Matsumura T,Naya M,Yamori M,Hojo M,Hibi S,Todo S

    更新日期:1997-08-01 00:00:00

  • Pre-emptive immunotherapy with purified natural killer cells after haploidentical SCT: a prospective phase II study in two centers.

    abstract::Adoptive immunotherapy with allogeneic purified natural killer (NK) cell products might exert graft-versus-tumor alloreactivity with little risk of GVHD. In a prospective phase II study in two centers, we administered purified NK cell products to high-risk patients treated with haploidentical T-cell-depleted SCT. Sixt...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1038/bmt.2012.162

    authors: Stern M,Passweg JR,Meyer-Monard S,Esser R,Tonn T,Soerensen J,Paulussen M,Gratwohl A,Klingebiel T,Bader P,Tichelli A,Schwabe D,Koehl U

    更新日期:2013-03-01 00:00:00

  • Early recovery of aggressive cytotoxic cells and improved immune resurgence with post-transplant immunotherapy for multiple myeloma.

    abstract::A phase I/II trial evaluated early administration and dose escalation of interleukin (IL)-2 with granulocyte macrophage colony stimulating factor (GM-CSF) post-transplant. Following melphalan (200 mg/m(2)) and an autologous transplant, IL-2 was initiated (day 0) and continued for 4 weeks. GM-CSF (250 mcg/m(2)/day) beg...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1705665

    authors: Meehan KR,Wu J,Bengtson E,Hill J,Ely P,Szczepiorkowski Z,Kendall M,Ernstoff MS

    更新日期:2007-06-01 00:00:00

  • Horse antilymphocytic globulin in hepatitis B exacerbation after bone marrow transplantation adoptive immunity transfer.

    abstract::We describe the case of a HBsAg+, HBeAg+ carrier, treated with lamivudine, who experienced exacerbation of hepatitis after BMT from an anti-HBs+, anti-HBc+, anti-HBe+ donor. The serological profile of the donor and the timing of exacerbation suggested that the adoptive immunity transfer played a major pathogenetic rol...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1704471

    authors: Favre C,Menconi MC,Nardi M,Casazza G,Oliveri F,Macchia P,Bonino F,Brunetto MR

    更新日期:2004-05-01 00:00:00

  • Use of intrathecal chemoprophylaxis in children after SCT and the risk of central nervous system relapse.

    abstract::Conflicting conclusions can be drawn from the available data concerning antileukemic efficacy and risks of intrathecal (i.t.) chemoprophylaxis to children after hematopoietic SCT (HSCT). To address this, we enrolled six transplantation centers with similar treatment and patient material. Of the 397 children included, ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章,多中心研究

    doi:10.1038/bmt.2010.121

    authors: Rubin J,Vettenranta K,Vettenranta J,Bierings M,Abrahamsson J,Békássy AN,Håkansson Y,Frost BM,Arvidson J,Spendilow C,Winiarski J,Gustafsson B

    更新日期:2011-03-01 00:00:00

  • Integration of humoral and cellular HLA-specific immune responses in cord blood allograft rejection.

    abstract::In allo-stem cell transplantation (SCT), it is unclear whether donor-specific anti-HLA Abs (DSAs) can actually mediate graft rejection or if they are simply surrogate markers for the cellular immunity that causes graft rejection. Here, we first analyzed a case of cord blood allograft rejection in which DSA and cytotox...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2015.119

    authors: Hanajiri R,Murata M,Sugimoto K,Murase M,Sakemura R,Goto T,Watanabe K,Imahashi N,Terakura S,Ohashi H,Akatsuka Y,Kurahashi S,Miyamura K,Kiyoi H,Nishida T,Naoe T

    更新日期:2015-09-01 00:00:00

  • Intravenous ribavirin therapy for adenovirus cystitis after allogeneic bone marrow transplantation.

    abstract::Acute hemorrhagic cystitis due to adenovirus infections may be more severe or protracted in immunocompromised patients. This patient with chronic graft-versus-host disease following allogeneic marrow transplantation for acute myelogenous leukemia developed painful hematuria due to adenovirus infection that failed to r...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Cassano WF

    更新日期:1991-03-01 00:00:00

  • Thrombotic microangiopathy following allogeneic bone marrow transplantation is associated with intensive graft-versus-host disease prophylaxis.

    abstract::Thrombotic microangiopathy (TM), manifesting clinically as thrombotic thrombocytopenic purpura or hemolytic uremic syndrome, is an uncommon complication after bone marrow transplantation (BMT). A retrospective analysis of potential risk factors for TM following allogeneic BMT was performed. Clinical data were analyzed...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701359

    authors: Paquette RL,Tran L,Landaw EM

    更新日期:1998-08-01 00:00:00

  • Porcine hematopoietic cell xenotransplantation in nonhuman primates is complicated by thrombotic microangiopathy.

    abstract::Thrombotic microangiopathy (TM) is a serious complication of bone marrow transplantation (BMT) that resembles thrombotic thrombocytopenic purpura (TTP). In attempting to achieve hematopoietic cell chimerism in the pig-to-baboon model, we have observed TM following infusion of high doses (>10(10) cells/kg) of porcine p...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1703067

    authors: Bühler L,Goepfert C,Kitamura H,Basker M,Gojo S,Alwayn IP,Chang Q,Down JD,Tsai H,Wise R,Sachs DH,Cooper DK,Robson SC,Sackstein R

    更新日期:2001-06-01 00:00:00

  • Hemopoietic stem cell processing: comparison of progenitor cell recovery using the Cobe 2991 cell washer and the Haemonetics V50 apheresis system.

    abstract::Using 24 bone marrow (BM) harvests intended for cryopreservation and transplantation, we compared the use of the Cobe 2991 cell washer (2991) and the Haemonetics V50 apheresis system (HV50) for automated BM processing. Our in vitro data indicate that while the mononuclear cell (MNC) concentration of the HV50 product w...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Preti RA,Ahmed T,Ayello J,Helson L,Argani I,Wuest D,Ciavarella D

    更新日期:1992-05-01 00:00:00

  • Pregnancy after bone marrow transplantation for severe aplastic anemia.

    abstract::Two women suffering from severe aplastic anemia were treated by bone marrow transplantation (BMT). They became pregnant 17 and 40 months after the procedure. During the first 20 weeks of pregnancy, one of them continued to receive cyclosporin A (CSA) to prevent graft-versus-host disease. Her CSA serum levels during th...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:

    authors: Schmidt H,Ehninger G,Dopfer R,Waller HD

    更新日期:1987-10-01 00:00:00

  • Identification of amplified clonal T cell populations in the blood of patients with chronic graft-versus-host disease: positive correlation with response to photopheresis.

    abstract::Chronic graft-versus-host disease (cGVHD) is a multiorgan disorder with skin manifestations resembling scleroderma. Since photopheresis, a treatment that induces an anticlonotypic immune response, has proven to be effective in both cutaneous T cell lymphomas with circulating clonal T cells and in cGVHD, we have search...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1703705

    authors: French LE,Alcindor T,Shapiro M,McGinnis KS,Margolis DJ,Porter D,Leonard DG,Rook AH,Foss F

    更新日期:2002-10-01 00:00:00

  • Progenitor and lymphoma cells in blood stem cell harvests: impact on survival following transplantation.

    abstract::This study evaluated whether cytokine-induced blood stem cell mobilization also mobilized lymphoma cells and whether lymphoma cell mobilization affected outcome post autologous blood stem cell transplant. Blood stem cell collections from 26 non-Hodgkin's lymphoma (NHL) patients harvested during steady-state (non-mobil...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1703124

    authors: Demirkazik A,Kessinger A,Armitage JO,Bierman PJ,Lynch J,Vose J,Chan W,Sharp JG

    更新日期:2001-07-01 00:00:00

  • Growth and endocrine function in patients with Hurler syndrome after hematopoietic stem cell transplantation.

    abstract::Short stature is characteristic of Hurler syndrome, or mucopolysaccharidosis type IH (MPS IH). Hematopoietic stem cell transplantation (HSCT) is used to treat children with MPS IH. While HSCT corrects some of the metabolic features of MPS IH, its effects on growth are not well delineated. We investigated growth in pat...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/bmt.2008.20

    authors: Polgreen LE,Tolar J,Plog M,Himes JH,Orchard PJ,Whitley CB,Miller BS,Petryk A

    更新日期:2008-06-01 00:00:00

  • Early infections in patients undergoing bone marrow or blood stem cell transplantation--a 7 year single centre investigation of 409 cases.

    abstract::Infections are a major cause of morbidity and mortality in patients undergoing high-dose therapy and subsequent autologous or allogeneic haemopoietic stem cell transplantation, despite the change from topical to systemic anti-infection prophylaxis and the introduction of growth factors and new antimicrobial drugs. We ...

    journal_title:Bone marrow transplantation

    pub_type: 杂志文章

    doi:10.1038/sj.bmt.1701614

    authors: Krüger W,Rüssmann B,Kröger N,Salomon C,Ekopf N,Elsner HA,Kaulfers PM,Mack D,Fuchs N,Dürken M,Kabisch H,Erttmann R,Zander AR

    更新日期:1999-03-01 00:00:00