Autologous Bone Marrow Transplantation - Blog Science Connections

10 BAVC + ABMT in Patients With AML in CR
PATIENTS AND METHODS
The techniques of marrow collection, cryopreservation, and thawing have
been previously described (5). Pretransplant chemotherapy consisted of the
BAVC regimen (Fig 1): BCNCI (carmustine) (800 mg/m 2
on day 1), amsacrine
(150mg/m 2 i.v. on days 2 to 4), VP-16-213 (etoposide) (150 mg/m 2 i.v. on
days 2 to 4), cytarabine (150 mg/m 2 i.v. every 12 hours from days 2 to 4).
Marrow cells were reinfused 24 hours after the last dose of chemotherapy.
Of the 39 AML patients who underwent ABMT, 30 (11 were females and 28
were males) were in CR1. The median age was 27 years (range, 1-14 years).
Nine patients (four of whom were females) were treated while in CR2. Two
patients in this group also had M 3
leukemia. The median age for patients in CR2
was 24 years (range, 10-47 years). The median durations of CR before
transplantation were 5 months (range, 1-14 months) and 4 months (range,
1-25 months) for patients receiving treatment in CR1 and CR2, respectively.
Eighteen patients (60%) who underwent ABMT during CR1 received the
same induction and consolidation treatment, which consisted of two cycles of
daunorubicin (DNR) plus cytarabine (3 + 7 and 2 + 5, respectively) followed by
four courses of DNR plus cytarabine plus 6-thioguanine, with an escalating dose
of cytarabine from cycles 1 to 4. The other 12 patients received the same
induction but different consolidation therapies, which, in 6 of them, consisted of
high-dose cytarabine plus DNR. Marrow was collected and cryopreserved
immediately before starting pretransplant chemotherapy. Four patients, whose
leukemic clonogenic cells totally reacted to an antilactofucopentaose HI S4-7
u u n
-5
DRVS
-s -I
BCNU BOO mg/tqm
RMSR ISO mg/tqm
I
UP-16 150 mg/sqm
B8S
RRR-C 150 mg/tqm ql2h c.l.
Figure 1. BAVC
regimen.