In adult patients affected by Acute Myeloid Leukaemia (AML), Autologous Bone Marrow Transplantation (ABMT) offers a clinical advantage over conventional chemotherapy in terms of Disease Free Survival (DFS), although relapse still remains a frequent cause of failure. Pharmacological in vitro purging of bone marrow inoculum using mafosfamide or 4-hydroperoxycyclophosphamide (4HC) could reduce relapse risk, hence this technique has been used extensively by some groups over the last decade. Comparative data on the efficacy of in vitro purging in AML obtained in multi-centre retrospective studies result in beneficial effect of purging. No randomized study comparing purged and unpurged ABMT is available. A randomized study comparing ABMT using maphosphamide purged marrow versus chemotherapy failed to demonstrate advantages in purged ABMT arm in term of OS or DFS. On the other hand, in retrospective multicenter studies, purging resulted in a reduced rate of treatment failures with respect to unpurged ABMT. Furthermore, direct comparisons between purged and unpurged marrow in AML patients, obtained in a single institution, are scarce.
Giuseppe Milone, Autologous Transplantation in 1st Cr Aml Patients with Purged or Unpurged Bone Marrow: Good Clinical Results in Favorable Cytogenetic Group and in those Infused with a Low Number of Marrow Cells
Last date updated on July, 2014