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

Abstract

Eighteen patients with small cell carcinoma of the lung received high dose cyclophosphamide (180-200 mg/kg) intensification following five 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). They received infusions of autologous bone marrow which had been stored at 4 degrees C for 34 h. Pancytopenia was predictable in onset and its duration acceptable. Recovery of neutrophils to greater than 1.0 x 10(9)/l was achieved in 17.5 +/-0.9 d (mean +/- SEM) and platelets to greater than 100 x 10(9)/l in 17.5 +/- 0.8 d. Four patients with acute myeloid leukaemia 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 degrees C for 54 h. Haematological reconstitution in these patients was acceptable but slower (greater than 1.0 x 10(9)/l neutrophils between days 26 and 40; greater than 20 x 10(9)/l platelets between days 23 and 77). Except in one case, normal peripheral counts were attained in all patients. It is concluded that bone marrow stored at 4 degrees C for up to 54 h is a simple and practical source of viable stem cells which have the capacity for acceptable haematological reconstitution.