Autologous Bone Marrow Transplantation - Blog Science Connections

Autologous Transplantation of Circulating Stem
Cells in Acute Nonlymphocytic Leukemia
Josy Reiffers, Gerald Marit, Philippe Bernard, Bernard David,
Anne Sarrat, Jean Chevaleyre, Rida Bouzgarrou,
Françoise Feuillatre, Gérard Vezon,
and Antoine Broustet
Autologous cryopreserved marrow cells have been used for several years to
restore hematopoiesis after myeloablative chemoradiotherapy. More recently,
the possibility of hematopoietic engraftment of peripheral blood stem cells
(PBSC) has been considered in patients with acute leukemias (1-4), non-
Hodgkin's lymphomas (5,6), or solid tumors (7). Since the number of PBSC
is often very low, however, the collection of sufficient circulating progenitors
may be difficult. In patients with acute nonlymphocytic leukemia (ANLL), we
previously reported that an overshoot in colony-forming units of granulocytemacrophage
stem cells (CFCJ-GM) occurs during recovery from myelosuppressive
chemotherapy. Performed during this period, leukaphereses
enabled us to collect a mean of 15.2 x 10 4
CFU-GM cells/kg per leukapheresis
from 11 patients in first complete remission (CR) and 4.4 x 10 4
CFCJ-GM
cells/kg from 6 patients in second or subsequent CR (8). Thus, the number of
CFCJ-GM cells collected by means of four to six leukaphereses was equivalent
or greater than that usually obtained from a marrow harvest. To evaluate the
hematopoietic capacity of PBSC, we performed autologous PBSC trans-
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