Autologous Peripheral Blood Stem Cell Transplantation Using G-CSF Combined Conditioning in AML Patients

급성 골수성 백혈병 환자에서 G-CSF를 포함한 고용량 화학요법 후 자가 말초혈 조혈모세포이식의 효과

  • Kim, Byung Soo (Department of Internal Medicine, Korea University Medical Center) ;
  • Kook, Hoon (Department of Pediatrics, Chonnam National University Hospital) ;
  • Hwang, Tai Ju (Department of Pediatrics, Chonnam National University Hospital) ;
  • Choi, Chul Won (Department of Internal Medicine, Korea University Medical Center) ;
  • Kim, Jun Suk (Department of Internal Medicine, Korea University Medical Center)
  • 김병수 (고려대학교 의과대학 내과학교실) ;
  • 국훈 (전남대학교 의과대학 소아과학교실) ;
  • 황태주 (전남대학교 의과대학 소아과학교실) ;
  • 최철원 (고려대학교 의과대학 내과학교실) ;
  • 김준석 (고려대학교 의과대학 내과학교실)
  • Published : 2002.03.31

Abstract

Background: The possibility that G-CSF recruits leukemic cells from the G0 to S phase, which may lead to a greater susceptibility to cytotoxic drugs, such as ara-C, has been presented in Harada's study. Methods: In this study, we referred to the protocol of Harada et al 1 to try G-CSF combined marrow-ablative chemotherapy and autologous PBSCT, for the treatment of AML patients in CR1 status. Between January 1997 and March 1998, six AML patients (3: children, 3: adults) in CR1 status were autografted and followed up to 3 years. Results: The major regimen related toxicity was composed of mucositis and diarrhea without death. The time of ANC recovery to 500/L and 1,000/L was 11~48 and 16~81 days, respectively. The mean time of platelet recovery to 20,000/L and 50,000/L was 21~233 and 35~370 days, respectively. The platelet recovery time to 50,000/L was markedly prolonged for more than 100 days in four patients (66.7%). Moreover, four patients (66.7%) experienced a relapse of leukemia after transplantation, with a mean interval of 147.5 days after PBSCT. Two patients were in CR status for 53 and 51 months after PBSCT, respectively. Conclusion: The G-CSF combined marrow-ablative chemotherapy and autologous PBSCT resulted in a markedly delayed platelet recovery and no advantages for decreasing the relapse rate of AML. But, further studies will be warranted.

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