Autologous Bone Marrow Transplantation - Blog Science Connections

4-Hydroperoxycyclophosphamide and Vincristine
as Ex Vivo Bone Marrow Treatment for Acute
Leukemia in Second Remission
Leonard J. Horwitz, Miklos L. Auber, Sangeeta Khorana,
Sundar Jagannath, KarelA. Dicke, and Gary Spitzer
A major drawback of autologous bone marrow transplantation (ABMT) in
acute leukemia is the likely presence of occult leukemic cells in the remission
marrow (1). Physical, immunological, and pharmacological procedures or
their combinations have been used in animal models to eliminate this
leukemic cell contamination (2,3).
MATERIALS AND METHODS
The cyclophosphamide derivatives, Asta Z 7557 (mafosfamide) and
4-hydroperoxycyclophosphamide (4-HC), are among the drugs commonly
used for ex vivo chemotherapy (chemopurging) of harvested marrow (4-7).
Clinical studies of ex vivo chemotherapy with 4-HC (40-120 ug/m\) and
ABMT suggest that a small percentage of acute myeloid leukemic (AML)
patients, most of them in second complete remission (CR2), may achieve
long-term disease-free survival. These patients have usually had a previous
complete remission of relatively long duration (18 months or more). Ex vivo
marrow treatment with 4-HC has been less successful for acute lymphoid
143