High-dose therapy in @entity1582 : effect of positive selection of XXXX + peripheral blood stem cells on hematologic engraftment and clinical outcome.

@entity1 @entity1261 @entity1885 @entity882 @entity786 @entity1582 @entity1398 @entity3053 @entity1863 @entity2280 @entity2259
BACKGROUND AND OBJECTIVE: Positive selection of peripheral blood stem cells (PBSC) has been investigated in @entity1582 ( @entity1582 ) with the aims of reducing plasma cell (PC) contamination of the leukaphereses and improving clinical outcome of autografted @entity1 . DESIGN AND METHODS: In our center 39 untreated @entity1 with stage II and III @entity1582 , younger than 65 years, started high-dose therapy consisting of 4 VAD cycles, collection of PBSC mobilized by 7 g/m(2) @entity786 + @entity1261 , and myeloablative treatment with 12 mg/kg @entity1863 plus 120 mg/m(2) melphalan. The leukaphereses from 23/39 @entity1 (59%) were processed for positive selection of @entity2280 (+) cells using an avidin- @entity1885 immunoaffinity device. RESULTS: A reduction of PC contamination of as much as 2 log was found in the post-selection products by a flow-cytometric technique using the monoclonal antibody CD 138 alternatively coupled with @entity3053 and cytoplasmatic k or l light chains in separate samples. Hematologic reconstitution and clinical outcome of the 23 @entity1 reinfused with selected @entity2280 (+) cells (SEL group) were compared with those of the 16 @entity1 reinfused with unselected cells (UNSEL group). No significant differences were observed between the 2 groups with regards to the median duration of @entity1398 and @entity882 , the hematologic support required, the incidence of febrile episodes and @entity2259 . At a median follow-up of 18 months (range 5-34) after ASCT, there were 7/23 (32%) continuous complete remissions (CR) in the SEL group and 4/16 (25%) in the UNSEL group; there were 10/23 (44%) continuous partial remissions (PR) and 5/16 (31%) in the SEL and UNSEL groups, respectively. Two @entity1 in the UNSEL group and one @entity1 in the SEL group died of progressive disease. INTERPRETATION AND CONCLUSIONS: Our data show that positive selection allows rapid engraftment of hematopoiesis and low morbidity. Although no significant difference was detected between the two groups in the frequency of CR and PR 3 and 18 months after ASCT, a longer follow-up is needed to evaluate definitively the effect of @entity2280 (+) selection on the clinical outcome after ASCT.
