By Th. Büchner (auth.), W. Hinterberger, A. J. Barrett, K. Lechner, E. Deutsch (eds.)
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Extra resources for 11th Annual meeting of the EBMT: European Cooperative Group for Bone Marrow Transplantation
DISCUSSION These data indicate that neoplastic cells may survive and be detected up to several weeks after BMT without' evidence of persisting or recurring leukemia. Moreover, sequential chromosome studies have not allowed to observe neoplastic cells any more up to 70-200 days after their detection. Lawler et Al. demonstrated that recipient cells may still be detected in the bone marrow some weeks after BMT for acute leukemia, without signs of relapse (I). We think that mechanisms other than cell destruction (immunological?
We had individualized two groups of patients : 1) Poor risk acute leukemia : 11 patients (Phl chromosome, secondary leukemia of breast cancer, partial remission, second or subsequent remission). The results are poor (6 deaths, 3 relapses (meningeal and medullary), 2 CR (3 months+, 4 months+)). 2) Standard risk ( first complete remission) : 13 patients (5 ALL, 8 ANLL). 1 relapse at 14th month posl-graft ~LLl), 1 death of liver veino-occlusive disease. The all 11 remain in complete remission, 2 at 20 months + after graft (median 13 months).
Ol). * Marrow cleansing was not associated with improvement both from DFS and survival anolysis, neither in CRl nor in CR2. Althouqh the difference is not statistically siqnificant, there seems to be a trend in favour of autoqraftinq with non purqed marrow in patients in CR1. l)(not statistical1y significant). D - COMPARISON BETWEEN ALL AND ANLL : By DFS analysis, results were significant1y better for ANLL (79% versus 50%, on day 560 with a plateau until1 day RR7 for both. p (. OJ). 10 7 nucleated cells) - Also, as a consequence of the precited criteria, all these patients were treated by teams reportinq more than 10 ABMT.