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During 1984-86, 23 patients (5-37 years, median 16) with acute lymphoblastic leukemia (ALL) in first remission (n = 11) or beyond (n = 12) underwent autologous transplantation (ABMT) using marrow purged with the rat anti-CD52 monoclonal antibody Campath-1M after melphalan and total-body irradiation (TBI). Median time to 0.5 x 10(9)/L neutrophils and 50 x 10(9)/L platelets was 38 and 51 days respectively. Myeloid engraftment was significantly slower compared with ALL patients receiving unpurged marrow (P = .01). Eight patients died due to transplant-related causes 53-205 days after the procedure. Six of eight patients receiving 1150 cGy TBI died of toxicity compared with two of 15 receiving less than 1150 cGy (P = .006, Fisher's exact test). Nine patients relapsed at 45-195 days (median 97); eight died and one is alive at nine years in a chemotherapy-induced remission. Six patients are alive and well in continuous remission 9-10 years (median 10) after transplant. The 10-year probabilities of disease-free survival and relapse are 26% (95% CI: 11-45%) and 51% (95% CI: 37-59%) respectively. We conclude that it is feasible to purge marrow for autografting using Campath-1M without killing normal stem cells. Myeloid engraftment is slow but consistent, and long-term survival is seen in a proportion of patients. The role of CD52 monoclonal antibodies for purging in ALL still requires further study.

Original publication




Journal article


Leukemia & lymphoma

Publication Date





479 - 486


Leukaemia Unit, Royal Marsden Hospital, Sutton, Surrey, UK.


Animals, Humans, Rats, Melphalan, Methotrexate, Glycoproteins, Antineoplastic Combined Chemotherapy Protocols, Antigens, CD, Antibodies, Monoclonal, Antigens, Neoplasm, Bone Marrow Purging, Combined Modality Therapy, Whole-Body Irradiation, Bone Marrow Transplantation, Transplantation, Autologous, Follow-Up Studies, Time Factors, Adolescent, Adult, Child, Child, Preschool, Female, Male, Precursor Cell Lymphoblastic Leukemia-Lymphoma, CD52 Antigen, Mercaptopurine