Journal Mobile Options
Table of Contents
Vol. 114, No. 4, 2005
Issue release date: November 2005
Acta Haematol 2005;114:206–213

The Significance of Minimal Residual Disease in Stem Cell Grafts and the Role of Purging: Is It Better to Purge in vivo or in vitro?

Melillo L. · Cascavilla N. · Lerma E. · Corsetti M.T. · Carella A.M.
Division of Hematology and Stem Cell Unit, IRCCS S. Giovanni Rotondo and Division of Hematology, Azienda Ospedaliera Universitaria San Martino, Genova, Italy

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Contamination of autologous graft by tumor, in addition to incomplete tumor eradication, can partly explain why relapse remains the commonest cause of treatment failure after autologous stem cell transplantation (ASCT) in patients with malignant hematologic disorders. Monitoring of minimal residual disease (MRD) is now recognized as an important diagnostic tool for assessment either of the response to treatments aimed at maximal cytoreduction and the individual risk of relapse. In order to improve cure rates, many strategies to achieve in vivo or in vitro reduction, if not eradication, of residual disease have been proposed. We discuss the significance of MRD and the role of purging in the ASCT setting, focusing on acute myeloid leukemia, chronic myeloid leukemia, multiple myeloma and follicular lymphoma.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Barlogie B, Jagannath S, Vesole DH, Naucke S, Cheson B, Mattox S, Bracy D, Salmon S, Jacobson J, Crowley J, Tricot G: Superiority of tandem autologous transplantation over standard therapy for previously untreated multiple myeloma. Blood 1997;89:789–793.
  2. Hunault-Berger M, Ifrah N, Solal-Celigny P, Groupe Ouest-Est des Leucémies Aiguës et des Maladies du Sang: Intensive therapies in follicular non-Hodgkin lymphomas. Blood 2002;100:1141–1152.
  3. Mehta J, Powles R, Singhal S, Treleaven J: Peripheral blood stem cell transplantation may result in increased relapse of acute myeloid leukemia due to reinfusion of a higher number of malignant cells. Bone Marrow Transplant 1995;15:652–653.
  4. Goldie J, Coldman AJ: A genetic instability in the development of drug resistance. Semin Oncol 1985;12:222–230.
  5. Campana D, Coustan-Smith E, Janossy G: The immunological detection of minimal residual disease in acute leukemia. Blood 1990;76:163–171.
  6. Tanaka K, Arif M, Eguchi M, Kumuravel TS, Ueda R, Ohno R, Iwato K, Kyo T, Dohy H, Kamada N: Application of fluorescence in situ hybridisation to detect residual leukemic cells with 9;22 and 15;17 translocations. Leukemia 1997;11:436–440.
  7. Cross NCP: Quantitative PCR techniques and applications. Br J Haematol 1995;89:693–697.
  8. Van Dongen JJM, MacIntyre EA, Gabert JA, Elabesse E, Rossi V, Saglio G, et al: Standardized RT-PCR analysis of fusion genes transcripts from chromosome aberrations in acute myeloid leukemia for detection of minimal residual disease. Leukemia 1999;13:1901–1928.
  9. Child JA, Morgan GJ, Davies FE, Owen RG, Bell SE, Hawkins K, Brown J, Drayson MT, Selby PJ: High-dose chemotherapy with hematopoietic rescue for multiple myeloma. N Engl J Med 2003;348:1875–1883.
  10. Mariette X, Fermand JP, Brouet JC: Myeloma cell contamination of peripheral blood stem cell grafts in patients with multiple myeloma treated by high-dose therapy. Bone Marrow Transplant 1994;14:47–50.
  11. Henry JM, Sykes PJ, Brisco MJ, To LB, Juttner CA, Morley AA: Comparison of myeloma cell contamination of bone marrow and peripheral blood stem cell harvests. Br J Haematol 1996;92:614–619.
  12. Galimberti S, Morabito F, Guerrini F, Palumbo GA, Azzara A, Martino M, Benedetti E, Di Raimondo F, Petrini M: Peripheral blood stem cell contamination evaluated by a highly sensitive method fail to predict outcome of autotransplanted multiple myeloma patients. Br J Haemat 2003;120:405–412.
  13. Vogel W, Kopp HG, Kanz L: Myeloma cell contamination of peripheral blood stem-cell grafts can predict the outcome in multiple myeloma patients after high-dose chemotherapy and autologous stem-cell transplantation. J Cancer Clin Oncol 2005;131:214–218.
  14. Attal M, Harousseau JL, Stoppa AM, et al: A prospective randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. N Engl J Med 1996;335:91–97.
  15. Moreau P, Facon T, Leleu X, et al: Recurrent 14q32 translocations determine the prognosis of multiple myeloma, especially in patients receiving intensive chemotherapy. Blood 2002;100:1579–1583.
  16. Facon T, Avet-Loiseau H, Guillerm G, et al: Chromosome 13 abnormalities identified by FISH analysis and serum beta-2-microglobulin produce a powerful myeloma staging system for patients receiving high-dose therapy. Blood 2001;97:1566–1571.
  17. Brenner MK, Rill DR, Krance RA, Mirro J, Anderson WF, Ihle JN: Gene-marking to trace origin of relapse after autologous bone-marrow transplantation. Lancet 1993;341:85–86.
  18. Keating S, Suciu S, De Witte T, Zittoun R, Mandelli F, Belhabri A, Amadori S, Fibbe W, Gallo E, Fillet G, Varet B, Meloni G, Hagemeijer A, Fazi P, Solbu G, Willemze R on the behalf of the EORTC-GIMEMA Leukemia Group: The stem cell mobilizing capacity of patients with acute myeloid leukemia in complete remission correlates with relapse risk: Results of the EORTC-GIMEMA AML-10 trial. Leukemia 2003;17:60–67.
  19. Feller N, Schuurhuis GJ, Van der Pol MA, Westra G, Weijers GWD, Van Stijn A, Huijgens PC, Ossenkoppele GJ: High percentage of CD34 positive cells in autologous peripheral blood cell stem products reflects inadequate in vivo purging and low chemotherapeutic toxicity in a subgroup of patients with poor clinical outcome. Leukemia 2003;17:68–75.
  20. Ferrant A, Frassoni F, Prentice HG, Cahn JY, Blaise D, Reiffers J, et al., on behalf of the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation (EBMT): Karyotype in acute myeloblastic leukemia: prognostic significance for bone marrow transplantation in first remission: a EBMT study. Blood 1997;90:2931–2938.
  21. Kusec R, Laczika K, Knobl P, Friedl J, Greinix H, Kalths P, et al: AML1/ETO fusion mRNA can be detected in remission blood samples of all patients with t(8;21) acute myeloid leukemia after chemotherapy or autologous bone marrow transplantation. Leukemia 1994;8:736–739.
  22. Diverio D, Rossi V, Avvisati G, De Santis S, Pistilli S, Pane F, et al: Early detection of relapse by prospective reverse transcriptase-polymerase chain reaction analysis of the PML/RAR alpha fusion gene in patients with acute promyelocytic leukemia enrolled in the GIMEMA-AIEOP multicenter ‘AIDA’ trial. Blood 1998;92:784–789.
  23. Laczika K, Novak M, Hilgarth B, Mitterbauer M, Mitterbauer G, Scheidel-Petrovic A, et al: Competitive CBFbeta/MYH11 RT-PCR for quantitative assessment of minimal residual disease during post-remission therapy in acute myeloid leukemia with inversion (16): A pilot study. J Clin Oncol 1998;16:1519–1525.
  24. Schiller GJ: Clinical and biological features of favorable-risk acute myelogenous leukemia – is favorable-risk AML really favorable? Leukemia 2005;19:326–328.
  25. Melillo L, Specchia G, Ferrara F, Minervini MM, Pastore D, Carella AM: Comparison of leukemic contamination in peripheral blood stem cells and bone marrow after consolidation therapy in acute myeloid leukemia: not a critical factor in outcome? Haematologica 2003; 88:709–711.
  26. Kolitz JE, George SL, Dodge RK, et al: Consolidation therapy by cytogenetic risk in adults with acute myeloid leukemia <60 years in first complete remission: results of CALGB 9621. Blood 2001;97:3574–3580.
  27. Cilloni D, Gottardi E, De Micheli D, Serra A, Volpe G, Messa F, Rege-Cambrin G, Guerrasio A, Divona M, LoCoco F and Saglio G: Quantitative assessment of WT1 expression by real-time quantitative PCR may be a useful tool for monitoring minimal residual disease in acute leukemia patients. Leukemia 2002;16:2115–2121.
  28. Ogawa H, Tamaki H, Ikegame K, et al: The usefulness of monitoring WT1 gene transcript for the prediction and management of relapse following allogeneic stem cell transplantation in acute type leukemia. Blood 2003;101:1698–1704.
  29. Schnitter S, Schoch C, Dugas M, et al: Analysis of FLT3 length mutations in 1003 patients with acute myeloid leukemia: correlation to cytogenetics, FAB subtype and prognosis in the AMLCG study and usefulness as a marker of minimal residual disease. Blood 2002;100:59–66.
  30. Bakshi A, Jensen JP, Goldman P, et al: Cloning the chromosome breakpoint of t(14;18) human lymphomas: clustering around JH on chromosome 14 and near a transcriptional unit on 18. Cell 1985;41:899–906.
  31. Moos M, Schulz R, Martin S, et al: The remission status before and the PCR status after high dose therapy with peripheral blood stem cell support are prognostic factors for relapse free survival in patients with follicular non-Hodgkin’s lymphoma. Leukemia 2000;12:1971–1976.
  32. Freedman AS, Neuberg D, Mauch P, Soiffer RJ, Anderson KC, Fisher DC, Schlossmann R, Alyea E, Takvorian T, Jallow M, Kuhlmann C, Ritz J, Nadler LM, Gribben JC: Long-term follow-up of autologous bone marrow transplantation in patients with relapsed follicular lymphoma. Blood 1999;94:3325–3333.
  33. Corradini P, Ladetto M, Zallio F, Astolfi M, Rizzo E, Sametti S, Cuttica A, Rosato R, Farina L, Boccadoro M, Benedetti F, Pileri A, Tarella C: Long-term follow-up of indolent lymphoma patients treated with high-dose sequential chemotherapy and autografting: evidence that durable molecular and clinical remission frequently can be attained only in follicular subtypes. J Clin Oncol 2004;22:1460–1468.
  34. Udomsakdi C, Eaves CJ, Swolin B, Reid DS, Barnett MJ, Eaves AC: Rapid decline of chronic myeloid leukemic cells in long-term culture due to a defect at the leukemic stem cell level. Proc Natl Acad Sci USA 1992;89:6192–6196.
  35. Udomsakdi C, Eaves CJ, Lansdorp PM, Eaves AC: Phenotypic heterogeneity of primitive leukemic hematopoietic cells in patients with chronic myeloid leukemia. Blood 1992;80:2522–2530.
  36. Coulombel L, Kalousek DK, Eaves CJ, Gupta CM, Eaves AC: Long-term marrow culture reveals chromosomally normal hematopoietic progenitor cells in patients with Philadelphia chromosome-positive chronic myelogenous leukemia. N Engl J Med 1983;308:1493–1498.
  37. Eaves AC, Eaves CJ, Phillips GL, Barnett MJ: Culture purging in leukemia: past, present, and future. Leuk Lymphoma 1993;11(suppl 1): 259–263.
  38. Verfaillie CM, Miller WJ, Boylan K, McGlave PB: Selection of benign primitive hematopoietic progenitors in chronic myelogenous leukemia on the basis of HLA-DR antigen expression. Blood 1992;79:1003–1010.
  39. de Fabritiis P, Petti MC, Montefusco E, De Propris MS, Sala R, Bellucci R, Mancini M, Lisci A, Bonetto F, Geiser T, Calabretta B, Mandelli F: BCR-ABL antisense oligodeoxynucleotide in vitro purging and autologous bone marrow transplantation for patients with chronic myelogenous leukemia in advanced phase. Blood 1998;91:3156–3162.
  40. Carella AM, Gaozza E, Raffo MR, Carlier P, Frassoni F, Valbonesi M, Lercari G, Sessarego M, Defferrari R, Guerrasio A, et al: Therapy of acute phase chronic myelogenous leukemia with intensive chemotherapy, blood cell autotransplant and cyclosporine A. Leukemia 1991;5:517–521.
  41. Carella AM, Podesta M, Frassoni F, Raffo MR, Pollicardo N, Pungolino E, Vimercati R, Sessarego M, Parodi C, Rabitti C, et al: Collection of ‘normal’ blood repopulating cells during early hemopoietic recovery after intensive conventional chemotherapy in chronic myelogenous leukemia. Bone Marrow Transplant 1993;12:267–271.
  42. Carella AM, Frassoni F, Melo J, Sawyers C, Eaves C, Eaves A, Apperley J, Tura S, Hehlmann R, Reiffers J, Lerma E, Goldman J: New insights in biology and current therapeutic options for patients with chronic myelogenous leukaemia. Haematologica 1997;82:478–495.
  43. Carella AM, Lerma E, Celesti L, Dejana A, Panagiotis Z, Corsetti MT, Frassoni F: Effective mobilization of Philadelphia-chromosome-negative cells in chronic myelogenous leukaemia patients using a less intensive regimen. Br J Haematol 1998;100:445–448.
  44. Corsetti MT, Lerma E, Dejana A, Basta P, Ferrara R, Benvenuto F, Vassallo F, Abate M, Piaggio G, Parodi C, Sessarego M, Li Pira G, Manca F, Carella AM: Quantitative competitive reverse transcriptase-polymerase chain reaction for BCR-ABL on Philadelphia-negative leukaphereses allows the selection of low-contaminated peripheral blood progenitor cells for autografting in chronic myelogenous leukemia. Leukemia 1999;13:999–1008.
  45. Simonsson B, Oberg G, Killander A, Bjoreman M, Bjorkholm M, Gahrton G, Stenke L, Turesson I, Uden AM, Malm C, et al: Intensive treatment in order to minimize the Ph-positive clone in chronic myelogenic leukemia (CML). Swedish CML-group. Bone Marrow Transplant 1994;14(suppl 3):S55–S56.
  46. Hui CH, Goh KY, White D, Branford S, Grigg A, Seymour JF, Kwan YL, Walsh S, Hoyt R, Trickett A, Rudzki B, Ma DD, To LB, Hughes TP: Successful peripheral blood stem cell mobilisation with filgrastim in patients with chronic myeloid leukaemia achieving complete cytogenetic response with imatinib, without increasing disease burden as measured by quantitative real-time PCR. Leukemia 2003;17:821–828.
  47. Drummond MW, Marin D, Clark RE, Byrne JL, Holyoake TL, Lennard A, United Kingdom Chronic Myeloid Leukaemia (UK CML) Working Party: Mobilization of Ph chromosome-negative peripheral blood stem cells in chronic myeloid leukaemia patients with imatinib mesylate-induced complete cytogenetic remission. Br J Haematol 2003;123:479–483.
  48. Kreuzer KA, Kluhs C, Schwarz M, Dorken B, Le Coutre P: Safety and efficacy of stem cell mobilization under imatinib therapy. Review. Haematologica 2003;88:1199–1200.
  49. O’Brien SG, Guilhot F, Larson RA, Gathmann I, Baccarani M, Cervantes F, Cornelissen JJ, Fischer T, Hochhaus A, Hughes T, Lechner K, Nielsen JL, Rousselot P, Reiffers J, Saglio G, Shepherd J, Simonsson B, Gratwohl A, Goldman JM, Kantarjian H, Taylor K, Verhoef G, Bolton AE, Capdeville R, Druker BJ, IRIS Investigators: Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukaemia, N Engl J Med 2003;348:994–1004.
  50. Lemoli RM, Fortuna A, Motta MR, Rizzi S, Giudice V, Nannetti A, Martinelli G, Cavo M, Amabile M, Mangianti S, Fogli M, Conte R, Tura S: Concomitant mobilization of plasma cells and hematopoietic progenitors into peripheral blood of multiple myeloma patients: positive selection and transplantation of enriched CD34+ cells to remove circulating tumor cells. Blood 1996;87:1625–1634.
  51. Webb IJ, Friedberg W, Gribben JG, et al: Effective purging of autologous hematopoietic stem cells using anti B-cell monoclonal antibody-coated high-density microparticles prior to high-dose therapy for patients with non-Hodgkin lymphoma. Biol Blood Marrow Transplant 2002;8:429–434.
  52. Gribben JG, Saporito L, Barber M, et al: Bone marrows of non-Hodgkin lymphoma patients with a BCL-2 translocation can be purged of polymerase chain-reaction-detectable lymphoma cells using monoclonal antibodies and immunomagnetic bead depletion. Blood 1993;80:1083–1089.
  53. San Miguel JF, Almeida J, Mateo G, Blade J, Lopez-Berges C, Caballero D, Hernandez J, Moro MJ, Fernandez Calvo J, Diaz-Medaivilla J, Palomera L, Orfao A: Immuno-phenotypic evaluation of the plasma cell compartment in multiple myeloma: A tool for comparing the efficacy of different treatment strategies and predicting outcome. Blood 2002;99:1853–1856.
  54. Lemoli RM, Martinelli G,Zamagni E, Motta MR, Rizzi S,Terragna C, Rondelli R, Ronconi S, Curti A, Bonifazi F, Tura S, Cavo M: Engraftment, clinical and molecular follow-up of patients with multiple myeloma who were reinfused with highly purified CD34+ cells to support single or tandem high-dose chemotherapy. Blood 2000;95:2234–2239.
  55. Stewart AK, Vescio K, Schiller G, et al: Purging of autologous PBSC using CD34 selection does not improve overall or progression free survival after high-dose therapy for multiple myeloma: results of a multicenter randomized controlled trial. J Clin Oncol 2001;198:3771–3779.
  56. Godschmidt H, Bouko Y, Bourhis JH, et al: CD34+ selected PBPCT results in an increased infective risk without prolongation of event free survival in newly diagnosed myeloma: a randomized study from the EBMT. Blood 2001;98:815.
  57. Barbui AM, Galli M, Dotti G, et al: Negative selection of peripheral blood stem cells to support a tandem autologous transplantation programme in multiple myeloma. Br J Haematol 2002;116:202–210.
  58. Gorin NC, Aegerter P, Auvert B, Meloni G, Goldstone AH, Burnett A, Carella A, Korbling M, Herve P, Maraninchi D: Autologous stem cell transplantation for acute myeloid leukemia in first remission: a European survey of the role of bone marrow purging. Blood 1990;75:1606–1614.
  59. Miller CB, Rowlings PA, Zhang M, et al: The effect of graft purging with 4-hydroperoxy-cyclophosphamide in autologous bone marrow transplantation for acute myeloid leukemia. Exp Hematol 2001;29:1336–1346.
  60. Laporte J, Douay L, Lopez M, Labopin M, Jouet SP, Lesage S, Stachowiak J, Fouillard L, Isnard F, Noel-Walter MP: One hundred twenty-five adult patients with primary acute leukemia autografted with marrow purged by mafosfamide: A 10-year single institution experience. Blood 1994;84:3810–3818.
  61. Fauth F, Martin H, Sonnhoff S, et al: Purging of G-CSF mobilized peripheral autografts in acute leukemia with mafosfamide and amifostine to protect normal progenitor cells. Bone Marrow Transplant 2000;25:831–836.
  62. Ball ED, Wilson J, Phelps V, Neudorf S: Autologous bone marrow transplantation for acute myeloid leukemia in remission or first relapse using monoclonal antibody-purged marrow: results of phase II studies with long-term follow up. Bone Marrow Transplant 2000;25:823–829.
  63. Larson RA: Current use and future development of Gentuzumab Ozogamicin. Semin Hematol 2001;38;3(suppl 6):24–31.

    External Resources

  64. Tse WM, Lazarus HM, van Besien K: Stem cell transplantation in follicular lymphoma: progress at last? Bone Marrow Transplant 2004;34:929–938.
  65. Ladetto M, Corradini P, Vallet S, et al: High rate of clinical and molecular remissions in follicular lymphoma patients receiving high-dose sequential chemotherapy and autografting at diagnosis: A multicenter, prospective study by the Gruppo Italiano Trapianto Midollo Osseo (GITMO). Blood 2002;100:1559–1565.
  66. Apostolidis J, Gupta RK, Grenzelias D, Johnson PW, Pappa VI, Summers KE, Salam A, Adams K, Norton AJ, Amess JA, Bradburn M, Lister TA, Rohatiner AZ: High-dose therapy with autologous bone marrow support as consolidation of remission in follicular lymphoma: long-term clinical and molecular follow-up. J Clin Oncol 2000;18:527–536.
  67. Schouten HC, Qian W, Kvaloy S, Porcellini A, Hagberg H, Johnson HE, Doorduijn JK, Sydes MR, Kvalheim G: High-dose therapy improves progression-free survival and survival in relapsed follicular non-Hodgkin’s lymphoma: results from the randomized European CUP trial. J Clin Oncol 2003;21:3918–3927.
  68. van Besien K, Loberiza FR, Bajorunaite R, et al: Comparison of autologous and allogeneic hematopoietic stem cell transplantation for follicular lymphoma. Blood 2003;102:3521–3529.
  69. Flinn IW, O’Donnell PV, Goodrich A, et al: Immunotherapy with rituximab during peripheral blood stem cell transplantation for non-Hodgkin’s lymphoma. Biol Blood Marrow Transplant 2000;6:628–632.
  70. Lenz G, Dreyling M, Schiegnitz E, et al: Myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission prolongs progression-free survival in follicular lymphoma – results of a prospective randomized trial of the German Low-Grade Lymphoma Study Group (GLSG). Blood 2004;104:2667–2674.
  71. Deconinck E, Foussard C, Bertrand P, et al: Value of autologous stem cell transplantation in first line therapy of follicular lymphoma with high tumor burden: final results of the randomized GOELAMS 064 Trial (abstract). Blood 2003;646.
  72. Gopal AK, Gooley TA, Maloney DG, Petersdorf SH, Eary JF, Rajendran JG, Bush SA, Durack LD, Golden J, Martin PJ, Matthews DC, Appelbaum FR, Bernstein ID, Press OW: High-dose radioimmunotherapy versus conventional high-dose therapy and autologous hematopoietic stem cell transplantation for relapsed follicular non-Hodgkin lymphoma: a multivariable cohort analysis. Blood 2003;102:2351–2357.
  73. Fouillard L, Laporte JP, Labopin M, Lesage S, Isnard F, Douay L, Lopez M, Aoudjane M, Zunic P, Cheron N, Stachowiak J, Lemonnier MP, Andru G, Belkauni Y, Noel-Walter MP, Morel P, Fenaux P, Jouet JP, Bouters B, Nagman A, Gorin NC: Autologous stem-cell transplantation for non-Hodgkin’s lymphomas: The role of graft purging and radiotherapy posttransplantation – results of a retrospective analysis on 120 patients autografted in a single institution. J Clin Oncol 1998;16:2803–2816.
  74. Bierman PJ, Sweetenham JW, Loberiza FM, Taghipour G, Lazarus HM, Rizzo JD, Schmitz N, van Besien K, Vose J, Horowitz M, Golstone A: Syngeneic hematopoietic stem cell transplantation for non-Hodgkin’s lymphoma: a comparison with allogeneic and autologous transplantation. J Clin Oncol 2003;21:3744–3753.
  75. Lemieux B, Tartas S, Traulle C, Espinouse D, Thieblemon K, Bouafia F,Alhusein Q, Antal D, Salles G, Coiffier B: Rituximab-related late-onset neutropenia after autologous stem cell transplantation for aggressive non-Hodgkin’s lymphoma. Bone Marrow Transplant 2004;33:921–923.
  76. Gidron A, Verma A, Doyle M, Boggio L, Evens A, Gordon L, Singhal S, Tallman M, Williams S, Winter J, Mehta J: Can the stem cell mobilization technique influence CD34+ cell collection efficiency of leukapheresis procedures in patients with hematologic malignancies? Bone Marrow Transplant 2005;35:243–246.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50