AUTOLOGOUS BMT FOR POSTREMISSION THERAPY IN ADULT ALL - AN IMMUNOLOGICAL APPROACH

Among patients included in the multicentric trial ALL87, 95 patients w ere randomly allocated to purged ABMT arm for post-remission therapy. Immunological phenotyping performed in patients at diagnosis allowed t o assigned 51 patients (54%) to the B lineage and 34 patients (36%) to the T lineage. Only 64 patients (67%) actually received ABMT mainly b ecause of early relapses. Fifty-two patients were depleted according t o the protocol: 25 B-ALL were depleted with CD10+CD19 mAbs, 19 T-ALL w ith CD2+CD5+CD7 mAbs and 8 patients received an Asta-Z purged BMT. Amo ng the 12 remaining patients, 4 received Asta-Z purged BMT and 8 an un purged one. Using an intention to treat analysis, overall survival and event free survival were similar to results observed in chemotherapy group. This study emphasizes the importance of a precise phenotyping a t ALL diagnosis which allows specific immunologic bone marrow purging for ABMT.