Peripheral Blood Stem Cell Autografts (PBSCT) for the Treatment of Childhood T-Cell Acute Lymphoblastic Leukemia or Non-Hodgkin's Lymphoma with Mediastinal Mass

Abstract

Seven children (3-17 y; median, 10 y), who had acute lymphoblastic leukemia (ALL) or non-Hodgkin's lymphoma (NHL) associated with mediastinal mass, underwent high-dose chemotherapy (MCVAC therapy) and peripheral blood stem cell autografts (PBSCT). None received total body irradiation. Four patients had ALL and three had NHL. In all patients, cancer cells had T cell surface makers. Five patients, including one with initial induction failure ALL, underwent PBSCT in the first complete remission (CR) and two patients did in the second CR. One patient received mediastinal irradiation before PBSCT. After PBSCT, hematopoietic recovery speed was fast and five of the seven patients have survived without relapse for 11-58 months. One patient, who had underwent initial PBSCT in the 1st CR and developed relapse, underwent the second PBSCT and still has remained in unmaintained CR for 18 months post-PBSCT. The data suggest that high-dose chemotherapy and PBSCT will become an effective therapeutic option for this particular group of patients.