Single-institution results of autologous bone marrow transplantation in acute myeloid leukemia

• Published in: Haematologica (Roma) 1995-03, Vol.80 (2), p.136-141
• Main Authors: Lambertenghi Deliliers, G, Annaloro, C, Della Volpe, A, Oriani, A, Mozzana, R, Pozzoli, E, Tagliaferri, E, Soligo, D
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bone Marrow Transplantation - mortality; Bone marrow, stem cells transplantation. Graft versus host reaction; Combined Modality Therapy; Disease-Free Survival; Female; Follow-Up Studies; Graft Survival; Humans; Leukemia, Myeloid - drug therapy; Leukemia, Myeloid - mortality; Leukemia, Myeloid - therapy; Male; Medical sciences; Remission Induction; Salvage Therapy; Survival Rate; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Treatment Outcome
• ISSN: 0390-6078; 1592-8721

Centro Trapianti di Midollo, Ospedale Maggiore di Milano, I.R.C.C.S. Universita degli Studi di Milano, Italy. BACKGROUND. Current results of autologous bone marrow transplantation (ABMT) suggest that this procedure may prolong disease-free survival (DFS) in patients with acute myeloid leukemia (AML). MATERIALS AND METHODS. Over the last ten years, 29 AML patients received unpurged autologous bone marrow (BM) after a conditioning regimen including Ara-C (3 g/m2/12h, days -9, -8), CTX (60 mg/kg/day, days -6, -5) and TBI (3.33 Gy/day, days -3 through -1). In 21 patients, ABMT was performed as late intensification after first CR. Eight more relapsing patients were autografted after the achievement of second CR. RESULTS. Three patients died from transplant-related complications. In the remaining patients, mean times to WBC and platelet recovery were, respectively, 23 days (range 13-55) and 55 days (range 22-790). Follow-up for censored patients ranged from 1 to 120 months. Relapse occurred in 7 patients (5 in first and 2 in second CR). Overall 5-year DFS and event-free survival (EFS) chances were, respectively, 67.3% and 60%, with no statistically significant differences between first (DFS = 67.3%, EFS = 60.3%) and second CR (DFS = 68.6%, EFS = 60%). DISCUSSION. Apart from obvious selection biases, our study suggests that outcome in first CR AML patients is improved by ABMT. Long-term DFS and EFS are clearly better than when conventional post-remission chemotherapies are used. The greater antileukemic potential of ABMT is further underlined by the results in patients autografted in second CR, when conventional chemotherapy is almost never curative.