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218 CBV and ABMT in Hodgkin s Disease PATIENTS AND METHODS Sixty-two patients with relapsed Hodgkin's disease were treated with high-dose chemotherapy and autologous bone marrow transplantation (ABMT) at two referral institutions. Informed consent for participating in the study was obtained from each patient. The median age was 28 years (range, 15-56 years). There were 36 males. The median time from diagnosis to transplantation was 31 months (range, 6-111 months). The performance status in Zubrod's scale was 0 (36 patients), 1(18 patients), and 2 or 3 (8 patients). Mo patient had major organ failure at the time of entry in the study. The median number of previous chemotherapy regimens patients had failed was two (range, 1 -5 regimens). All but three patients had received both a MOPP-like regimen and a doxorubicin-containing program. Twenty-nine patients had received an etoposide-containing combination chemotherapy. Twenty-four patients had not achieved a complete remission (CR) from the initial chemotherapy with or without additional radiation therapy. Thirtythree patients were progressing on the last salvage therapy. Forty-one patients had previous radiation therapy. The preparative regimen was CBV (4). The total dose of etoposide was 450 mg/m in the first patient; the dose was escalated to 600 2 mg/m in 21 2 patients, 750 mg/m 2 in 19 patients and, finally, 900 mg/m 2 in 21 patients. ABMT was performed on day 7. One patient with bone marrow disease had received marrow from a human leukocyte antigen matched and mixed lymphocyte culture nonreactive sibling. Further details on chemotherapy administration and treatment of Hodgkin's disease have been previously reported (4,5). RESULTS The overall survival for all 62 patients with relapsed Hodgkin's disease treated with CBV and ABMT is shown in Figure 1. The median survival is 26 months, with 33 patients alive at the time of this analysis. Sixty patients had measurable disease at the time of high-dose chemotherapy, while two were intensified in third complete remission (CR3). Twentyseven (45%) of the 60 patients went into CR, while 15 (25%) achieved a partial remission (PR). Six patients in PR received additional radiation therapy and have achieved CR; five of these remissions were durable at 12+, 12+, 13+, 26+, and 31+ months. Eight of the 27 patients in CR and one of the two patients intensified in CR3 have relapsed. One patient died of cytomegalovirus and Pneumocystis carinii pneumonia 5 months after bone marrow transplantation while still in remission, as shown by the autopsy. Figure 2 shows the disease-free survival for all 62 patients. Twenty-four patients are alive and free of disease with a median follow-up time of 19 months. Patients who achieve a complete response have an 85% projected 2-year
CBV and ABMT in Hodgkin's Disease 219 1 0 1 ALL PATENTS 62 * ALIVE 33 • ALIVE DISEASE FREE 24 12 —r~ 24 36 48 MONTHS 60 —r~ 72 —i 84 Figure 1. Survival and disease-free survival for all patients receiving CBV (cyclophosphamide, BCNU [carmustine], VP-16-213 [etoposide]) plus autologous bone marrow transplantation in relapsed Hodgkin's disease. 1.0 1 0.0 -\ 1 1 1 1 1—I 1 1 1 1 1 1 1 1 0 12 24 36 48 60 72 84 MONTHS Figure 2. Freedom from progression by risk groups receiving CBV( cyclophosphamide, BCNU [carmustine], VP-16-213 [etoposide]) plus autologous bone marrow transplantation for Hodgkin's disease.
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Autologous Bone Marrow Transplantat
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To our colleagues, Drs. R. Lee Clar
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via ABMT Autologous Bone Marrow Tra
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X ABMT Pharmacological Manipulation
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XII ABMT C. INTERNATIONAL RANDOMIZE
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xiu ABMT Session IV - Breast Cancer
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xui ABMT Panel Discussion: Session
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xuiii ABMT Effect of Interleukin 2
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Acknowledgments The publication of
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AML in First Remission 5 performed
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AML in First Remission 7 than 50% o
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10 BAVC + ABMT in Patients With AML
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BAVC + ABMT in Patients With AML in
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14 BAVC + ABMTin Patients With AML
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16 Purged ABMT in CR of Acute Leuke
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24 First-Remission Autograft forAML
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Transplantation in CRI AML 33 DISCU
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36 ABMT in ALL compared the results
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38 ABMT in ALL were administered un
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40 ABMT in ALL CR1 patients receive
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42 ABMT in ALL 19. Rizzoli V, Mango
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44 ABMTin CRI program in CR1 is the
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46 ABMTin CRI RESULTS The AML inves
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Leukemia: First Remission K A. Dick
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Panel Discussion: Session IA 51 DR.
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IB. Clinical Studies in Second- or
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56 ABMTIn CR2 RESULTS OF VARIOUS TR
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58 ABMTIn CR2 antibodies; for non-T
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60 ABMT in Acute Nonlymphocytic Leu
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70 ABMT in AML With Monoclonal Anti
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80 Mafosfamide Purging in Leukemia
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ABMT in CR2 Pediatric ALL 91 follow
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Ex Vivo Use of Monoclonal Antibodie
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Ex Vivo Marrow Purging 95 Table 1.
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De Viuo Marrow Purging 97 WBC-f- AN
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Conditioning Regimens Before Bone M
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Conditioning Regimens in AML 101 Le
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Conditioning Regimens in AML 103 co
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106 Double (Jnpurged ABMT in Leukem
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108 Double Unpurged ABMT in Leukemi
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770 Double (Jnpurged ABMT in Leukem
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7/2 Double Autografting in Acute Le
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114 Double Autografting in Acute Le
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120 Recovery After 4-Hydroperoxycyc
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122 Recovery After 4-Hydroperoxycyc
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Panel Discussion: Session IB 127 di
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Panel Discussion: Session IB 129 tu
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Magnetic Affinity Colloid Eliminati
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Magnetic Separation of Marrow Cells
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*r r- r» u. >>• O S ^ CO ai a> C
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4-Hydroperoxycyclophosphamide and V
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Chemopurging 145 incubation, the ce
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Chemopurging 147 To date, four pati
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Chemopurging 149 4-HC + VCR IC75 AM
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Decontaminating Bone Marrow With Me
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Merocyanine 540 Marrow Decontaminat
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Merocyanine 540 Marrow Decontaminat
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CALLA-Negative Clonogenic Cultures
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CALLA-Negatiœ Clonogenic BCell ALL
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CALLA-Negative Clonogenic BCell ALL
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164 Acetaldophosphamide Ex Vivo Che
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766 Acetaldophosphamide Ex Vivo Che
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Page 195 and 196: Detecting Residual Disease in Bone
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Page 202 and 203: 178 Pharmacological Manipulation an
Page 211: ID. Chronic Myelogenous Leukemia
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Page 223 and 224: Autologous Transplantation of Phila
Page 225 and 226: Autografting in Chronic Granulocyti
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Page 230 and 231: 206 Panel Discussion: Session ID DR
Page 233 and 234: Natural History of Relapsed Hodgkin
Page 235 and 236: ABMT in Hodgkin's Disease 211 50%.
Page 237 and 238: ABMTin Hodgkin, 's Disease 213 (62%
Page 239 and 240: ABMT in Hodgkin's Disease 215 LLLLL
Page 241: Updated Results of CBV and Autologo
Page 245: CBV and ABMT in Hodgkin 's Disease
Page 248 and 249: 224 Chemotherapy and ABMT in Hodgki
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Page 258 and 259: 234 ABMTfor Advanced Hodgkin's Dise
Page 261 and 262: Hodgkin's Disease J. O. Armitage an
Page 263 and 264: Panel Discussion: Session IIA 239 D
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Page 279 and 280: ABMT in Burkitt's Lymphoma 255 Heal
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Page 288 and 289: 264 Myeloma Biology and Therapy hig
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265 Myeloma Biology and Therapy 5.
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270 BMT in Relapsed Diffuse Large C
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276 Transplantation for Malignant L
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Optimum Timing of Autologous Bone M
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ABMT Timing in Lymphoma 281 PATIENT
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3 o + + + + o LO T— T— LO co Tf
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ABMT Timing in Lymphoma 285 RESULTS
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co co I I I I I I I I I I 2 2 2 CD
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ABMT Timing in Lymphoma 289 Median
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ABMT Timing in Lymphoma 291 in a mi
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ABMT Timing in Lymphoma 293 Develop
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ABMT Timing in Lymphoma 295 53. Sto
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298 Treatment Strategies for NHL PA
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300 Treatment Strategies for NHL 10
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302 Treatment Strategies for NHL 2)
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304 Treatment Strategies for NHL al
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306 Treatment Strategies for NHL 31
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308 Panel Discussion: Session IIB m
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IIC. International Randomized Study
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314 Proposed International Adult Ly
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International Randomized Trial in N
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International NHL Trial 337 dispari
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International NHL Trial 339 cannot
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International NHL Trial 341 ORGANIZ
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Lymphoma T. Philip and G. Spitzer,
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IID. Purging and Detection
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348 Chemoimmunoseparation of T Lymp
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350 Chemoimmunoseparation of T Lymp
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352 Burkitt's Lymphoma Purging Assa
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354 Burkitts Lymphoma Purging Assay
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356 Burkitt's Lymphoma Purging Assa
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358 Burkitts Lymphoma Purging Assay
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360 Purging Methods in Burkitt's Ly
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366 Leukemia Cell Sensitivity to Im
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368 Leukemia Cell Sensitivity to Im
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370 Leukemia Cell Sensitiuity to Im
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372 Panel Discussion: Session IID D
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ABMTfor Neuroblastoma 377 sedimenta
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ABMT for Neuroblastoma 379 EX VIVO
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ABMTfor Neuroblastoma 381 PATIENTS
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Repeated High-Dose Chemotherapy Fol
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ABMT in Metastatic Neuroblastoma 38
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ABMT in Metastatic neuroblastoma 39
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394 Clnpurged ABMTfor Neuroblastoma
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396 Unpurged ABMTfor Neuroblastoma
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398 Unpurged ABMTfor Neuroblastoma
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ENSG 1—Randomized Study of High-D
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High-Dose Melphalan in Neuroblastom
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High-Dose Melphalan in Neuroblastom
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408 ABMTin 65 Patients With Neurobl
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410 ABMT in 65 Patients With. Neuro
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416 ABMTin 65 Patients With neurobl
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A Single Institution's Experience o
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ABMT in Neuroblastoma 421 procedure
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ABMT in Neuroblastoma 423 therapies
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426 Purged Marrow Engraftment in Ne
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Digital Image Analysis System for D
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Digital Image Analysis System 435 d
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Digital Image Analysis System 437 c
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Digital Image Analysis System 439 C
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Digital Image Analysis System 441 1
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444 Immune-magnetic Purging ofBurki
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450 Panel Discussion: Session III W
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452 Panel Discussion: Session III e
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High-Dose Chemotherapy Intensificat
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High-Dose Chemotherapy and ABMT in
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466 Treatment Strategies in Breast
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10 CO 0) I- m c o a. a. 3 W ? o k_
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476 Phase I and II Studies of Alkyl
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482 High-Dose Therapy and ABMT in B
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484 High-Dose Therapy and ABMT in B
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486 Immunodetection of Breast Carci
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ABMTfor Breast Cancer 491 only adju
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ABMT for Breast Cancer 493 Table 3.
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ABMTfor Breast Cancer 495 4. Eder J
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498 Occult Breast Cancer Cells in M
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504 Panel Discussion: Session IV DR
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506 Panel Discussion: Session IV a
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Detection of Bone Marrow Metastases
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Tumor Cell Detection 511 Two separa
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Tumor Cell Detection 513 immunofluo
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516 Etoposide and Cisplatin for Lun
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Lung Cancer G. Spitzer and H. Lazar
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Panel Discussion: Session V 525 com
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Panel Discussion: Session V 527 col
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Treatment of Advanced Melanoma With
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ABMT in Melanoma 533 Table 1. Three
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ABMT in Melanoma 535 mg/m 2 ). The
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Melanoma/ Sarcoma/ Carcinoma R. Ben
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Panel Discussion: Session VI 539 re
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VII. Brain Cancer
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544 Carmustine and ABMT for Maligna
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546 Carmustine and ABMTfor Malignan
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Pilot Study of High-Dose Carmustine
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High-Dose Carmustine and Transplant
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High-Dose Chemotherapy With Autolog
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High-Dose Therapy of CNS Gliomas Ta
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High-Dose Therapy of CHS Gliomas 56
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High-Dose Therapy of CHS Gliomas 56
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566 Panel Discussion: Session VII A
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VIII. New Regimens
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572 Clinical Intensification Regime
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574 Clinical Intensification Regime
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Clinical Intensification Regimens f
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Clinical Intensification Regimens f
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High-Dose Busulfan and Cyclophospha
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Busulfan + Cyclophosphamide in Chil
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The Intensive Use of Carmustine Wit
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Intensive Use ofCarmustine 591 6. P
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594 BEAM: Cytoreductive Regimen for
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596 BEAM: Cytoreductiue Regimen for
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602 Total Body Irradiation, Cytarab
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604 Total Body Irradiation, Cytarab
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606 Panel Discussion: Session VIII
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Herpesvirus Infections After Autolo
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Herpesvirus Infections 611 Table 2.
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Herpesvirus Infections 613 contrast
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616 Peripheral Stem Cell Transplant
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CO ^ CO COi-t'ycOi-T-CO O E « to T
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fc CD rr ^ O < c E + o — ce S O O
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o E ra o CD .Q Û ra co CL o E o 15
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634 Toxic Deaths in ABMT PATIENTS A
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636 Toxic Deaths in ABMT Table 2. D
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638 Toxic Deaths in ABMT defined an
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640 Infectious Complications ofABMT
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Infectious Complications of Autolog
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Infections in ABMT 649 Table 1. ABM
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Infections in ABMT 651 herpes simpl
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Newer Antibiotic Regimens in Cancer
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Antibiotics in Cancer Patients 655
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Antibiotics in Cancer Patients 657
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660 Amphotericin B for Neutropenic
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662 Amphotericin B for Neutropenie
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664 Amphotericin B for Neutropenie
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666 IVIg in ABMT in autologous tran
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668 IVlg in ABMT 25. Neiman PE, Ree
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670 Natural Killer Cells and Transp
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672 Natural Killer Cells and Transp
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Autologous Transplantation of Circu
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678 Transplantation of Circulating
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Restoration of Hematopoietic Functi
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Peripheral Stem Cell Transplants 68
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Peripheral Stem Cell Transplants 68
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688 Peripheral Blood Stem Cell Tran
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694 Bronchoscopy in Marrow Transpla
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696 Bronchoscopy in Marrow Transpla
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698 T Lymphocyte CFU After ABMT cer
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700 T Lymphocyte CFCI After ABMT RE
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702 T Lymphocyte CFU After ABMT CMV
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Supportive Therapy H. Vriesendorp a
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X. Molecular Biology
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770 Human ADA in Monkeys years in a
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7/2 Human ADA in Monkeys supernatan
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714 Human ADA in Monkeys Number of
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776 Human ADA in Monkeys primate ma
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718 Electric Field-Mediated DMA Tra
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720 Electric Field-Mediated DNA Tra
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Aberrant Gene Expression in Acute M
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+ z + + + les •ras a z E i ü (0
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Aberrant Gene Expression in AML 727
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Aberrant Gene Expression in AML 729
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732 Clonal Detection of Remission p
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734 Clonal Detection of Remission K
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736 Clonal Detection of Remission 3
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Summary D. W. van Bekkum Attempts t
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Summary 741 T cell-depleted bone ma
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Summary 743 hybridization technique
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Summary 745 GENETIC THERAPY The las
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748 Concluding Remarks time of the
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750 Contributors and Participants F
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754 Contributors and Participants P
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756 Contributors and Participants A
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758 Contributors and Participants P
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762 Contributors and Participants H
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764 Contributors and Participants A
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766 Contributors and Participants G
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770 Contributors and Participants S
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772 Contributors and Participants C
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776 Contributors and Participants D
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