自家骨髄移植

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  • Clinical trial of autologous bone marrow transplantation after <i>in vitro</i> monoclonal antibody and complement treatment in null cell type acute lymphocytic leukemia

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Autologous bone marrow transplantation (BMT) in null cell type acute lymphocytic leukemia (Null-ALL) was carried out after depletion of leukemia cells from transplanted marrow.<br>Patients' autologous bone marrow cells were harvested during remission and treated in vitro with baby rabbit complement (50%) and three monoclonal antibodies (NL-1 10μg/ml anti-CALLA IgG2a, NL-22 10μg/ml IgM and HL-47 10μg/ml IgM) reactive to Null-ALL cells, and then cryopreserved. Only cases whose leukemia cells were more than 90% lysed by in vitro treatment with monoclonal antibodies and complement were selected for this protocol.<br>Seven patients (6 y. o. M, 11F, 17M, 22M, 30M, 40M and 40M) were transplanted with the antibody-treated bone marrow cells during the first remission (six cases) or the second remission (one case) after preconditioning with intensive chemotherapy (cytosine arabinoside 2g/m2 4 doses at day -6, -5, -4. cyclophosphamide 60mg/kg 2 doses at day -5, -4) and total body irradiation (250_??_300 cGy at day-2, -1. 4 doses).<br>Good preservation of bone marrow was demonstrated in all seven cases studied, and infused bone marrow mononuclear cells were ranged from 0.11×108/kg to 0.35×108/kg. Clinically, prompt recovery of white blood cells was observed in six cases, and platelet recovery was prolonged in three cases. Four cases have continued complete remission for 42, 29, 24 and 21 months after BMT, while two cases relapsed after seven and six months remission, and one case had died of interstitial pneumonia in remission after 5months of BMT. These results suggested that autologous BMT with these three monoclonal antibodies may be an effective mode of therapy for high risk Null-ALL patients.

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