High-dose chemotherapy with autologous hematopoietic progenitor cell transplantation in children with high-risk NHL and ALL - Preliminary results.

Since May 95 to December 97 twenty children with NHL (n=14, NHL B = 11, NHL NE = 3) or ALL (n=6, high risk n=2, standard risk n=4) underwent high-dose chemotherapy with subsequent autologous hematopoietic progenitor cells tra nsplantation. In 19 children progenitor cells were harvested with the use o f Fenwal CS3000 Plus cell separator from the peripheral blood after cytotox ic mobilization with G-CSF (Neupogen 5 mu g/kg). One patient received PBPC and autologous bone marrow. One patient received positively selected CD34cells (CeprateSC, CellPro). One patient received autologous marrow purged w ith mafosfamide. All patients with NHL received conditioning according to B EAM protocol. Patients with ALL were conditioned with BU,CY,VP, BU,CY or BU . The median number of transplanted CD34+ cells was 3.84x10(6) (0.51x10(6)- 74.7x10(6)). Children transplanted with unmanipulated hematopoietic progeni tor cells recovered in granulocytes >500/mu l at a median time of 12 days ( range from 9 to 28 days). Platelet recovery >50000/mu l was observed at a m edian time of 26 days (range from 13 to 347days), Sixteen children (80 %) are alive and well in continuous complete remission from 4 to 36 months after transplantation (median +20). Three children (15 %) relapsed and died because of the disease. One patient died in complete remission on day +41 because of aspergillosis. Transplant related mortality was 5,0%. Overall survival was 79%. Event free survival was 86% in NHL and 67% in ALL.