title: Autologous bone marrow transplantation in late first complete remission improves outcome in acute myelogenous leukemia.
abstract: We evaluated the role of ABMT in late 1st CR AML adult patients using busulfan plus cyclophosphamide as preparative regimen. Fifty-one adult patients (mean age 36 years, range 15-59) with AML underwent ABMT in 1st CR. Three of them had a prior diagnosis of myelodysplastic syndrome; one patient had a secondary leukemia. The median interval between CR and ABMT was 8 months (range 4-20). Patients received busulfan, 4 mg/kg/day for 4 days plus cyclophosphamide 50 mg/kg/day for 4 days or 60 mg/kg/day for 2 days. No maintenance chemotherapy was administered after ABMT. Median days to reach 0.5 x 10(9)/I PMN and 20 x 10(9)/I platelets were 26 (range 12-250) and 74 (range 16-740), respectively. No transplant-related deaths were observed. Five-year actuarial overall survival rate is 76.9%; actuarial leukemia-free survival rate is 70.6%. Mean follow-up from ABMT is 35 months. Leukemia-free survival of this group was compared with that of 38 non-transplanted patients younger than 60 years, who maintained a CR longer than 8 months in the same period. This analysis shows a statistically significant difference in favor of ABMT patients. These results suggest that, even if performed late after 1st CR as post-remission intensification, ABMT can improve the outcome of AML patients.
authors.affiliation: Istituto di Ematologia Seràgnolí, Università di Udine, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Miggiano
authors.forename: F
authors.initials: F
authors.lastname: Gherlinzoni
authors.forename: G
authors.initials: G
authors.lastname: Rosti
authors.forename: G
authors.initials: G
authors.lastname: Bandini
authors.forename: G
authors.initials: G
authors.lastname: Visani
authors.forename: M
authors.initials: M
authors.lastname: Fiacchini
authors.forename: P
authors.initials: P
authors.lastname: Ricci
authors.forename: N
authors.initials: N
authors.lastname: Testoni
authors.forename: M R
authors.initials: MR
authors.lastname: Motta
authors.forename: A
authors.initials: A
authors.lastname: Geromin
authors.forename: S
authors.initials: S
authors.lastname: Rizzi
authors.forename: A
authors.initials: A
authors.lastname: Belardinelli
authors.forename: S
authors.initials: S
authors.lastname: Mangianti
authors.forename: S
authors.initials: S
authors.lastname: Manfroi
authors.forename: S
authors.initials: S
authors.lastname: Tura
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction; D015996:Survival Rate; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D002066:Busulfan; D015255:Idarubicin; D003630:Daunorubicin