Haematological reconstitution following high dose and supralethal chemo‐radiotherapy using stored, non‐cryopreserved autologous bone marrow

Abstract

Patients (18) with small cell carcinoma of the lung received high dose cyclophosphamide (180-200 mg/kg) intensification following 5 pulses of CHOP chemotherapy (cyclophosphamide 750 mg/m2 i.v., adriamycin 50 mg/m2 i.v., vincristine 1.4 mg/m2 i.v., prednisolone 40 mg orally for 5 d [days]). They received infusions of autologous bone marrow which had been stored at 4.degree. C for 34 h. Pancytopenia was predictable in onset and its duration acceptable. Recovery of neutrophils to > 1.0 .times. 109/l was achieved in 17.5 .+-. 0.9 d (mean .+-. SEM [standard error of the mean]) and platelets to > 100 .times. 109/l in 17.5 .+-. 0.8 d. Four patients with acute myeloid leukemia in complete remission received intensification with the supralethal combination of cyclophosphamide and total body irradiation followed by infusion of autologous marrow which had been stored at 4.degree. C for 54 h. Hematological reconstitution in these patients was acceptable, but slower (> 1.0 .times. 109/l neutrophils between days 26-40; > 20 .times. 109/l platelets between days 23-77). Except in 1 case, normal peripheral counts were attained in all patients. Bone marrow stored at 4.degree. C for up to 54 h apparently is a simple and practial source of viable stem cells which have the capacity for acceptable hematological reconstitution.