Morishima Y, Miyamura K, Kojima S, Ueda R, Morishita Y, Sao H, Tanimoto M, Ohno R, Sobue R, Hirano M
First Department of Internal Medicine, Nagoya University, Japan.
Bone Marrow Transplant. 1993 Apr;11(4):255-9.
Autologous BMT (auto-BMT) has been conducted for 17 high-risk common ALL antigen (CALLA)-positive non-T cell type ALL patients. Ex vivo purging of leukemia cells from infused BM cells was performed using complement and three kinds of mouse monoclonal antibodies reactive to CALLA-positive leukemia cells: NL-1 (IgG2a), NL-22 (IgM), and HL-47 (IgM). Minimal residual leukemia cells in BM were examined by PCR method in Philadelphia chromosome (Ph1)-positive ALL cases. BCR/ABL chimeric transcript, which was positive in BM samples before purging, was shown to be absent after ex vivo purging in all three cases tested. Among four Ph1-positive cases transplanted in first CR, three cases survived in CR remission 77, 29 and 26 months after BMT, and one case died without relapse 4 months after BMT. The other four Ph1-negative cases transplanted in the first CR also remained in CR except one who relapsed. The results of minimal residual leukemia cell studies and clinical data indicate the effectiveness of our ex vivo leukemia cell purging method and auto-BMT in the early stage of CR for patients with high risk ALL.
已对17例高危普通急性淋巴细胞白血病抗原（CALLA）阳性非T细胞型急性淋巴细胞白血病患者进行了自体骨髓移植（auto - BMT）。使用补体和三种对CALLA阳性白血病细胞有反应的小鼠单克隆抗体：NL - 1（IgG2a）、NL - 22（IgM）和HL - 47（IgM），对输注的骨髓细胞进行白血病细胞的体外清除。采用聚合酶链反应（PCR）方法检测费城染色体（Ph1）阳性急性淋巴细胞白血病病例骨髓中的微小残留白血病细胞。在所有三个检测病例中，体外清除前骨髓样本中呈阳性的BCR/ABL嵌合转录本，在体外清除后均显示不存在。在首次完全缓解（CR）期进行移植的4例Ph1阳性病例中，3例在骨髓移植后77、29和26个月处于CR缓解状态存活，1例在骨髓移植后4个月无复发死亡。在首次CR期进行移植的其他4例Ph1阴性病例中，除1例复发外，其余均保持CR状态。微小残留白血病细胞研究结果和临床数据表明，我们的体外白血病细胞清除方法和auto - BMT对高危急性淋巴细胞白血病患者在CR早期是有效的。
