Au, WY

Chim, JCS

Kwong, YL

Lee, CK

Leung, AYH

Liang, RHS

Lie, AKW

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Title ICE/BEAM chemotherapy & peripheral blood stem cell (pbsc)rescue for relapse after bone marrow transplantation (BMT)Author(s) Au, WY; Lie, AKW; Lee, CK; Liang, RHS; Chim, JCS; Leung,AYH; Kwong, YLCitation The 5th Medical Research Conference, Hong Kong, China,January 2000, v. 22 n. Supp 2, p. 45Issued Date 2000URL http://hdl.handle.net/10722/46809Rights Creative Commons: Attribution 3.0 Hong Kong LicenseS-H-5ICE/BEAM chemotherapy & peripheral blood stem cell (pbsc) rescue for relapse after bone marrowtransplantation (BMT)W. Y. Au. A.K.W. Lie, C.K. Lee, R. Liang, C.S. Chim, Y.H. Leung, Y.L. Kwong. Department of Medicine,Queen Mary Hospital, Hong KongBackground: Prognosis of post-BMT relapse of leukemia/lymphoma is poor. We study the utility of intensivechemotherapy with allogeneic PBSC rescue in such patients, with a view to hastening marrow recovery andaugmenting the graft versus leukemia/lymphoma effect. Method: From 12/97-8/99, 9 cases (1 chronic myeloidleukemia blastic transformation (CML-BT),4 acute myeloid leukemia (AML),2 acute lymphoblastic leukemia(ALL), 1 nonHodgkin's lymphoma (NHL), 1 Hodgkin's disease (HD)) were treated. Chemotherapy was ICE(idarubicin, cytosine arabinoside, etoposide) for leukemia and mini-BEAM (BCNU, etoposide, cytosinearabinoside, melphalan) for lymphoma. Their median age was 40 (range 28-47). PBSC (median 2.3 x l06/kgCD34+ve cells, range 1.37-3.03) from previous donor was infused with no graft versus host disease (GVHD)prophylaxis. Results: All patients were high-risk cases. The median time to relapse was 45month (mo.) postBMT (range 4-80). The median time to white cell recovery was 12 days (range 8-16). Two patients (AML,CML-BT) died of refractory disease. Seven cases (78%) achieved morphological remission. Two patientsdied at 2 mo. (cerebral bleeding) and 4 mo. (relapse). Five cases (56%) are alive in remission (follow up 2-6mo.) One patient survived pulmonary aspergillosis with synegeneic PBSC rescue. Conclusions: Intensivechemotherapy and PBSC rescue is a feasible salvage option for post BMT relapse. Survival and remissionrates compare favorably with second BMT or palliative chemotherapy and donor lymphocyte infusion. Therapid neutrophil recovery reduced infective complications. No increased GVHD was apparent. Good resultsare expected for late relapses with preservation of donor chimerism.S-H-6THE RELATIONSHIP BETWEEN THE LEVELS OF GRANULOCYTE-COLONY STIMULATINGFACTOR AND LEUKOCYTOSIS INDUCED BY ALL-TRANS RETINOIC ACID IN ACUTEPROMYELOCYTIC LEUKEMIAWu Wen. Division of Haematology/Oncology and Bone Marrow Transplant Unit,UDM,QMHDifferentiation therapy with all-trans retinoic acid (ATRA) had been attemted with success in acute promyelocyticleukemia (APL) for many years,complete remission rates ranged between 80% to 90% in newly diagnosedpatients. Clinical response in 33-75% of the patients was accompanied by a transient rise in the peripheralleukocyte count. The "Retinoic Acid Syndrome" was the main cause of death in differentiation therapy. Inorder to explore the mechanism of leukocytosis, ELISA method was used in detecting levels of serum G-CSFin 47 cases of APL during treatment with ATRA. It was found that the peak of increased serum G-CSF leveloccured on the 9th day, and WBC number was the highest on 11th day. After ATRA treatment, both serumG-CSF level and WBC number increased in 68.1% of the cases. In 19.2% of the cases treated, serum G-CSFlevel was increased but without obvious change in WBC number, and the reverse was true in 12.7% of thecases.Serum G-CSF level was statistically correlated to the number of WBC, promyelocytes and its late stageby Spearman rank correlation analysis. There was no relationship between serum G-CSF level and lymphocyte.The result showed the change of WBC and serum G-CSF level in APL after the treatment with ATRA wereconnected.- 45 -

ICE/BEAM chemotherapy & peripheral blood stem cell (pbsc) rescue for relapse after bone marrow transplantation (BMT)

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ICE/BEAM chemotherapy & peripheral blood stem cell (pbsc) rescue for relapse after bone marrow transplantation (BMT)

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