AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR MYELOMA PATIENTS USING PNA-PURGED AND CD19-PURGED MARROW RESCUE

A new method of in vitro bone marrow purging using a lectin and monocl onal antibody in combination has been used for the first time in vivo. Two patients with advanced myeloma were treated with high-dose melpha lan and total body irradiation and then rescued with autologous bone m arrow which had been purged in vitro to remove malignant cells by usin g a combination of a plasma cell-binding lectin (peanut agglutinin, PN A) and the anti-B lymphocyte monoclonal antibody anti-CD19, bound to m agnetised microspheres. Both patients showed rapid engraftment of the purged bone marrow and remain well 36 and 46 months later with normal bone marrow morphology, although one patient still has a low level of circulating paraprotein. This is a promising form of therapy for what has been an invariably fatal condition.