High-dose chemotherapy with autologous hematopoietic progenitor cell transplantation in children with high-risk NHL and ALL-preliminary results

Bone Marrow Transplant. 1998 Dec:22 Suppl 4:S107-9.

Abstract

Since May 95 to December 97 twenty children with NHL (n=14, NHL B = 11, NHL NB = 3) or ALL (n=6, high risk n=2, standard risk n=4) underwent high-dose chemotherapy with subsequent autologous hematopoietic progenitor cells transplantation. In 19 children progenitor cells were harvested with the use of Fenwal CS3000 Plus cell separator from the peripheral blood after cytotoxic mobilization with G-CSF (Neupogen 5 microg/kg). One patient received PBPC and autologous bone marrow. One patient received positively selected CD34+ cells (CeprateSC, CellPro). One patient received autologous marrow purged with mafosfamide. All patients with NHL received conditioning according to BEAM protocol. Patients with ALL were conditioned with BU,CY,VP, BU,CY or BU. The median number of transplanted CD34+ cells was 3.84x10(6) (0.51x10(6)-74.7x10(6)). Children transplanted with unmanipulated hematopoietic progenitor cells recovered in granulocytes >500/microl at a median time of 12 days (range from 9 to 28 days). Platelet recovery >50000/microl was observed at a median time of 26 days (range from 13 to 347days). Sixteen children (80 %) are alive and well in continuous complete remission from 4 to 36 months after transplantation (median +20). Three children (15%) relapsed and died because of the disease. One patient died in complete remission on day +41 because of aspergillosis. Transplant related mortality was 5,0%. Overall survival was 79%. Event free survival was 86% in NHL and 67% in ALL.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Busulfan / administration & dosage
  • Busulfan / therapeutic use
  • Child
  • Child, Preschool
  • Cyclosporine / administration & dosage
  • Cyclosporine / therapeutic use
  • Etoposide / administration & dosage
  • Etoposide / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Platelet Count
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Survival Rate
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Etoposide
  • Cyclosporine
  • Busulfan