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- W1969132303 abstract "We have developed a sequential treatment strategy for intensive postremission management of adult ALL. Patients ⩾ 15 y in CRI receive melphalan (200mg/m<sup>2</sup>) followed by peripheral blood stem cells mobilized with G-CSF (Neupogen, Amgen). On hematologic recovery, 2 year maintenance chemotherapy with daily 6-MP and weekly MTX is started. In case of relapse, an allograft is performed with etoposide (60mg/kg) and TBI (1050 cGy) in CR2. 13 patients (6 M, 7 F; 32 y, 19<sup>_</sup>58) underwent PBSCT between 1/93 and 6/94. Toxicityof PBSCT was minimal with 2 d (0–5) of fever and 18 d (17–23) in hospital. Neutrophils reached 0.5 × 10<sup>9</sup>/L on d 15 (12–27), and platelets 50 × 10<sup>9</sup>/L on d 16 (12<sup>_</sup>77). 6-MP was started in 12 patients on day 32 (15<sup>_</sup>132). The median dose of 6-MP tolerated, averaged over the entire post-PBSCT follow-up period, was 45.4mg/m<sup>2</sup>/d. 10 patients (76.9%) are alive and well on chemotherapy in first CR at 18 mo (8<sup>_</sup>26). Of 3 patients relapsing at 4<sup>_</sup>7 mo, 2 are alive and well 7 and 8 mo after BMT from HLA matched siblings in CR2. The third declined ABMT in CR2 and died of relapsed disease. We conclude that melphalan-PBSCT and maintenance chemotherapy have minimal toxicity and significant anti-leukemic activity in adult ALL, and patients relapsing after PBSCT can be salvaged by a second BMT with acceptable toxicity." @default.
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- W1969132303 date "1995-11-01" @default.
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- W1969132303 title "811 Sequential high-dose therapy of adult acute lymphoblastic leukemia" @default.
- W1969132303 doi "https://doi.org/10.1016/0959-8049(95)96060-q" @default.
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