Autologous stem cell transplantation using modified TAM or combination of triple-alkylating agents conditioning regimens as one of the post-remission treatments in patients with adult acute myeloid leukemia in first complete remission

Bone Marrow Transplant. 2004 Aug;34(3):215-20. doi: 10.1038/sj.bmt.1704556.

Abstract

A total of 174 newly diagnosed adult acute myeloid leukaemia (AML) patients were treated in first complete remission (CR1) using modified TAM or a combination of triple-alkylating agents followed by autologous transplantation (AT). Cytogenetic risk groups were classified and most patients received mobilized peripheral blood stem/progenitor cells (PBSCs). The infused cell dose consisted of a median of 4.1+/-2 (range, 1.2-17.1)x 10(6)/kg CD34+ cells. With a median follow-up of 51 months (range, 5-131 months) after CR1, the estimated 5-year disease-free survival (DFS) rate was 68 (95% confidence interval (CI), 63-73%) and the event-free survival rate at 5 years was 59 (95% CI, 54-64%). AML patients other than M3 subtype, the long-term DFS rate was 76, 33% for favourable and unfavourable risk groups, respectively. In all, 40 patients had relapses (40/174, 23%) at the median 15 months after CR1 (range, 8-66 months). Overall, seven patients (4%) died in connection with AT. The infused CD34+ cell dose (P=0.0389) was associated with survival by multivariate analysis. In conclusion, two novel conditioning regimens in AT are feasible for adults with variable risk AML followed for over a 10-year period.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Alkylating Agents / therapeutic use*
  • Disease-Free Survival
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunophenotyping
  • Leukemia, Myeloid / classification
  • Leukemia, Myeloid / genetics
  • Leukemia, Myeloid / immunology
  • Leukemia, Myeloid / therapy*
  • Male
  • Middle Aged
  • Stem Cell Transplantation*
  • Time Factors
  • Transplantation Conditioning*
  • Transplantation, Autologous / physiology*

Substances

  • Alkylating Agents