Autologous Bone Marrow Transplantation - Blog Science Connections

Mafosfamide Purging in Leukemia 85
Engraftment
Clinical Results
Fifty of 52 patients showed consistent engraftment on reticulocytes and
WBCs. The other two patients did not experience engraftment because of
inadequate in vitro treatment that left no residual CFCI-GM or BFC1-E after
incubation. We observed a major difference in the patterns of hematopoietic
reconstitution between patients with ALL and ANLL on all parameters studied
(Table 2), grafting being significantly faster in ALL patients. Moreover, platelets
support had to be given for more than a year in three patients with ANLL.
Antileukemic Efficacy and Survival
These data are detailed in the chapter by N. C. Gorin et al.
DISCUSSION
Our preliminary in vitro studies demonstrated that CFCI-L were more
sensitive to mafosfamide than BFCI-E, but not more than CFCI-GM, which
confirmed our previous observations with 4-hydroperoxycyclophosphamide
(2). These results proved to us, however, that sensitivity to mafosfamide
depended on technical parameters such as RBC contamination. This was one
reason we elected to have all in vitro tests on buffy coat constantly adjusted to a
final hematocrit of 5%; the other reason was that, when we used pure
mononuclear fractions from Ficoll-Hypaque gradient-separated marrows, the
Table 2. Comparative Hematopoietic Recoveries In ALL and ANLL Patients
After Autologous Bone Marrow Transplantation With Marrow Treated In
Vitro by Mafosfamide
Hematopoietic Values
Median No. of Days to Recovery (range)
ALL
(n = 22)
ANLL
(n = 30) P Value a
0.1% reticulocytes 15 20.5