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552 High-Dose Carmustine and <strong>Transplantation</strong> for Gliomas Strategy 2: Chemotherapy Followed by Surgery If tumorectomy was not possible at diagnosis (as was true for seven patients) or at relapse, a biopsy examination was performed. After that, patients obtained high-dose carmustine, followed by an operation if possible. Patients then received the "conventional" chemotherapy (teniposide, carmustine, procarbazine) and finally underwent irradiation. Patients were treated in single rooms, without isolation procedures. The first four patients were hospitalized during the whole post-ABMT period, but supervision was quickly organized on an outpatient basis with a twice-weekly blood count, hepatic biologic assay, physical staging, and chest x ray. Evaluation of the response of patients with gliomas remains difficult because the only way to monitor these patients is by CT scan. In this study, the overall survival rate, which provided a rapid answer because of these patients' poor prognosis, was chosen as an evaluation criterion. Measuring the patients' quality of life was also a major objective of the pilot study. RESULTS Toxicity Carmustine and ABMT Toxicity The toxicity effects of the whole protocol, especially those of high-dose carmustine (Table 3), show different aspects and degrees. The immediate tolerance after a high dose of carmustine with grade 2 nausea and vomiting, was moderate. This is partially because of the short, 6-hour delay between bone marrow harvesting under general anesthesia and the carmustine infusion. Hematologic Toxicity Hematologic toxicity was mild. Three patients had a severe neutrocytopenia (< 1000 WBC/mm 3 and < 500 polyneutrophils/mm 3 ), which lasted fewer than 10 days in all three cases, but two patients had fever. In 12 patients (80%) no neutrocytopenia was observed. The platelet count evolution was similar: only two patients (13%) had a severe thrombocytopenia that required transfusions. The nadir of WBCs appeared at day 21, and for platelets at day 17. Consequently, almost all the patients, except the first ones, were followed as outpatients. Nonhematologic Toxicity Almost every patient presented with biological hepatic abnormalities on the cholestasis tests, but none had a clinical hepatitis or jaundice. Hepatic steatosis has, however, been found in the one autopsy performed. Three patients had leg phlebitis, and one patient had a pulmonary embolism 15 days after high-dose carmustine. Two patients had nondocumented fevers. One patient experienced
High-Dose Carmustine and <strong>Transplantation</strong> for Gliomas 553 Table 3. Toxic Effects No. of Characteristics Patients % Grading Nausea, vomiting 15 100 2 Hematologic toxicity 15 100 White blood cells 2 13.5 1 6 40 2 4 26.5 3 3 20
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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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168 Acetaldophosphamide Ex Viuo Che
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Detecting Residual Disease in Bone
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178 Pharmacological Manipulation an
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ID. Chronic Myelogenous Leukemia
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190 CML Chronic Phase Autografting
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196 CML Blast Crisis Autografting e
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Autologous Transplantation of Phila
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Autografting in Chronic Granulocyti
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Autografting in Chronic Granulocyti
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206 Panel Discussion: Session ID DR
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Natural History of Relapsed Hodgkin
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ABMT in Hodgkin's Disease 211 50%.
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ABMTin Hodgkin, 's Disease 213 (62%
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ABMT in Hodgkin's Disease 215 LLLLL
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Updated Results of CBV and Autologo
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CBV and ABMT in Hodgkin's Disease 2
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CBV and ABMT in Hodgkin 's Disease
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224 Chemotherapy and ABMT in Hodgki
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226 Chemotherapy and ABMTin Hodgkin
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232 ABMT for Advanced Hodgkin's Dis
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234 ABMTfor Advanced Hodgkin's Dise
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Hodgkin's Disease J. O. Armitage an
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Panel Discussion: Session IIA 239 D
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IIB. Non-Hodgkin's Lymphoma
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244 Salvage Chemotherapy for Lympho
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246 Salvage Chemotherapy for Lympho
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ABMT in Burkitt's Lymphoma 251 Tabl
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ABMT in Burkitt's Lymphoma 253 medi
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ABMT in Burkitt's Lymphoma 255 Heal
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ABMT in Burkitt's Lymphoma 257 •
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ABMT in Burkitt's Lymphoma 259 init
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ABMT in Burkitt's Lymphoma 261 11.
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264 Myeloma Biology and Therapy hig
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266 Myeloma Biology and Therapy mon
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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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500 Occult Breast Cancer Cells in M
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Page 533 and 534: Detection of Bone Marrow Metastases
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Page 555 and 556: Treatment of Advanced Melanoma With
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Page 565: VII. Brain Cancer
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Page 573 and 574: Pilot Study of High-Dose Carmustine
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Page 596 and 597: 572 Clinical Intensification Regime
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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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