Drexler, E.

Emmerich, B.

Langenmayer, Irmgard

Pachmann, K.

Pfefferkorn, L.

Straka, C.

English

Universität München: Elektronischen Publikationen

17S294 
Oktober 1994 
ISSN 0378-584 X 
I994:l7(suppl 2) :I -XXVI + I-174 
ONKOLOGIE 
• International Journal for Cancer Research and Treatment 
Supplement 2 
zu Band 17 
Oktober 1994 
Gemeinsame Jahrestagung der 
Deutschen und der 
Österreichischen Gesellschaft 
für Hämatologie und Onkologie 
Wien, 9.-12. Oktober 1994 
Abstracts 
Gemeinsame Jahrestagung der 
Deutschen und der 
Österreichischen Gesellschaft 
für Hämatologie und Onkologie 
Wien, 9.-12. Oktober 1994 
Abstracts 
Contents 
III Leitung und Organisation 
V-XV Author Index 
XVII-XXVI Subject Index 
1-172 Abstracts No. 1-686 
KARGER 
588 
A CONCEPT FOR THE TREATMENT OF RELAPSED INTERMEDIATE AND 
HIGH-GRADE NHL: STEM CELL COLLECTION AFTER LEV CHEMOTHERAPY 
PLUS G-CSF, IMMUNOMAGNETIC PURGING OF P.B.S.C. USING MOABS 
AGAINST B-CELL ANTIGENS IN PATIENTS WITH CB/CC NHL AND STEM CELL 
TRANSPLANTATION AFTER HIGH-DOSE BU/CY. 
C. Straka. I . Langenmayer, E. Drexler, L. Pfefferkorn, Κ. Pachmann & Β. Emmerich. 
Med. Klinik des Klinikums Innenstadt der Universität München, Ziemssenstr. 1, 80336 
München, Germany. 
Since 6/93 we have treated 13 patients with relapsed intermediate and high-grade NHL 
with IEV salvage chemotherapy (Ifosfamide 2.500 mg/nfi day 1-3, Epirubicin 100 mg/m^ 
day 1, VP-16 150 mg/m2 day 1-3) followed by G-CSF (Filgrastim 5 Mg/kg/d) at our 
institution. Leukapheresis was commenced at the time of rapid neutrophil recovery (ANC 
> 1 χ MP/1). Using either a Cobe Spectra or a Fresenius AS 104 cell separator, a median 
of 9.7 1 (range 4.8 1 - 14.6 1) of blood were processed during a median of 5 (range 2-10) 
collections. The aim was to collect an optimum number of progenitor cells (50 χ 10* 
CFU-GM/kg). This was possible in 9/13 patients. A median of 25,7 χ 104 CFU-GM/kg 
(range 0,13 - 367 χ 10* CFU-GM/kg) was collected per leukapheresis. The results show 
that IEV plus G-CSF has the potential to very effectively mobilise peripheral blood 
progenitor cells. 
3 patients have been transplanted so far after high-dose Bu/Cy (Busulfan 16 mg/kg, 
Cyclophosphamide 120 mgAtg). They have received optimum numbers of progenitor cells 
as autografts. In 1 patient it is too early to analyse the haematopoietic recovery. The other 
2 patients showed a fast engraftment and reached ANC > 0.5 χ \cPfl after 9 and 9 days and 
platelets > 50 χ 109/1 after 12 and 15 days. 
Today it has become obvious from several studies employing the PCR technique that 
there do exist circulating lymphoma cells in the majority of patients with cb/cc NHL, 
which will contaminate peripheral blood stem cell harvests (P.B.S.C). As a pilot study, 
we have started to purge the P.B.S.C. of patients with cb/cc NHL by applying an 
immunomagnetic technique. The MaxSep™ system (Baxter, München) is being used, 
which allows for the removal of cells expressing B-cell antigens from the autografts, 
including the residual lymphoma cells. A panel of 5 different mouse monoclonal 
antibodies (MoAbs) directed against the antigens CD19, CD20, CD22, CD23 and CD37 
is being used in conjunction with magnetic beads which carry sheep anti-mouse IgG. The 
bead/B-cell complexes are being removed from the autografts with a strong magnet Our 
initial experience shows that leukapheresis products can be purged directly without any 
further processing. We did not observe any cell clumping and the formation of bead/target 
cell rosettes as well as the results of the FACS analysis suggested that purging was 
successful. The actual purging efficacy, however, has to be determined by PCR. For this 
we either use a t(14;18) or a clone-specific PCR approach. The purging efficacy of clinical 
immunomagnetic purging by negative selection of B-cells is being compared with the 
purging effect of a positive selection of CD34+ cells. For this, an aliquot of the P.B.S.C. 
is used for the positive selection of CD34+ cells (Isolex™50, Baxter, München. 
147 


A concept for the treatment of relapsed intermediate and high-grade NHL: Stem dell collection after IEV chemotherapy plus G.CSF, immunomagnetic purging of P.B.S.C. using Moabs against B-cell antigens in patients with CB/CC NHL and stem cell transplantation after high-dose BU/CY.

Open Access LMU

17S294 Oktober 1994 ISSN 0378-584 X I994:l7(suppl 2) :I -XXVI + I-174 ONKOLOGIE • International Journal for Cancer Research and Treatment Supplement 2 zu Band 17 Oktober 1994 Gemeinsame Jahrestagung der Deutschen und der Österreichischen Gesellschaft für Hämatologie und Onkologie Wien, 9.-12. Oktober 1994 Abstracts Gemeinsame Jahrestagung der Deutschen und der Österreichischen Gesellschaft für Hämatologie und Onkologie Wien, 9.-12. Oktober 1994 Abstracts Contents III Leitung und Organisation V-XV Author Index XVII-XXVI Subject Index 1-172 Abstracts No. 1-686 KARGER 588 A CONCEPT FOR THE TREATMENT OF RELAPSED INTERMEDIATE AND HIGH-GRADE NHL: STEM CELL COLLECTION AFTER LEV CHEMOTHERAPY PLUS G-CSF, IMMUNOMAGNETIC PURGING OF P.B.S.C. USING MOABS AGAINST B-CELL ANTIGENS IN PATIENTS WITH CB/CC NHL AND STEM CELL TRANSPLANTATION AFTER HIGH-DOSE BU/CY. C. Straka. I . Langenmayer, E. Drexler, L. Pfefferkorn, Κ. Pachmann & Β. Emmerich. Med. Klinik des Klinikums Innenstadt der Universität München, Ziemssenstr. 1, 80336 München, Germany. Since 6/93 we have treated 13 patients with relapsed intermediate and high-grade NHL with IEV salvage chemotherapy (Ifosfamide 2.500 mg/nfi day 1-3, Epirubicin 100 mg/m^ day 1, VP-16 150 mg/m2 day 1-3) followed by G-CSF (Filgrastim 5 Mg/kg/d) at our institution. Leukapheresis was commenced at the time of rapid neutrophil recovery (ANC > 1 χ MP/1). Using either a Cobe Spectra or a Fresenius AS 104 cell separator, a median of 9.7 1 (range 4.8 1 - 14.6 1) of blood were processed during a median of 5 (range 2-10) collections. The aim was to collect an optimum number of progenitor cells (50 χ 10* CFU-GM/kg). This was possible in 9/13 patients. A median of 25,7 χ 104 CFU-GM/kg (range 0,13 - 367 χ 10* CFU-GM/kg) was collected per leukapheresis. The results show that IEV plus G-CSF has the potential to very effectively mobilise peripheral blood progenitor cells. 3 patients have been transplanted so far after high-dose Bu/Cy (Busulfan 16 mg/kg, Cyclophosphamide 120 mgAtg). They have received optimum numbers of progenitor cells as autografts. In 1 patient it is too early to analyse the haematopoietic recovery. The other 2 patients showed a fast engraftment and reached ANC > 0.5 χ \cPfl after 9 and 9 days and platelets > 50 χ 109/1 after 12 and 15 days. Today it has become obvious from several studies employing the PCR technique that there do exist circulating lymphoma cells in the majority of patients with cb/cc NHL, which will contaminate peripheral blood stem cell harvests (P.B.S.C). As a pilot study, we have started to purge the P.B.S.C. of patients with cb/cc NHL by applying an immunomagnetic technique. The MaxSep™ system (Baxter, München) is being used, which allows for the removal of cells expressing B-cell antigens from the autografts, including the residual lymphoma cells. A panel of 5 different mouse monoclonal antibodies (MoAbs) directed against the antigens CD19, CD20, CD22, CD23 and CD37 is being used in conjunction with magnetic beads which carry sheep anti-mouse IgG. The bead/B-cell complexes are being removed from the autografts with a strong magnet Our initial experience shows that leukapheresis products can be purged directly without any further processing. We did not observe any cell clumping and the formation of bead/target cell rosettes as well as the results of the FACS analysis suggested that purging was successful. The actual purging efficacy, however, has to be determined by PCR. For this we either use a t(14;18) or a clone-specific PCR approach. The purging efficacy of clinical immunomagnetic purging by negative selection of B-cells is being compared with the purging effect of a positive selection of CD34+ cells. For this, an aliquot of the P.B.S.C. is used for the positive selection of CD34+ cells (Isolex™50, Baxter, München. 147 

https://epub.ub.uni-muenchen.de/6914/1/6914.pdf

A concept for the treatment of relapsed intermediate and high-grade NHL: Stem dell collection after IEV chemotherapy plus G.CSF, immunomagnetic purging of P.B.S.C. using Moabs against B-cell antigens in patients with CB/CC NHL and stem cell transplantation after high-dose BU/CY.

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