The outcome of children with acute myeloid leukemia (AML) post-allogeneic stem cell transplantation (SCT) is not improved by the addition of etoposide to the conditioning regimen.
BACKGROUND
Relapse remains a concern for children with AML undergoing allogeneic SCT, so in an effort to reduce the risk of relapse in these patients, we intensified our pre-SCT preparation by adding etoposide to the standard busulfan and cyclophosphamide regimen.


METHODS
We retrospectively analyzed the collected data and compared the two groups; Group A (n = 18) included patients who received busulfan 16 mg/kg plus cyclophosphamide 200 mg/kg (Bu/Cy), and Group B (n = 48) included patients who received busulfan 12 mg/kg, cyclophosphamide 90 mg/kg in addition to etoposide 60 mg/kg (Bu/Cy/VP). The patients' characteristics were similar in the two groups.


RESULTS
No significant difference in the overall outcome was noted; the 5-year overall survival was 50% and 53.3% for Groups A and B, respectively (P = 0.9). Similarly, the 5-year probability of relapse was 64.1% and 46.1% for Groups A and B, respectively (P = 0.38). The use of etoposide was not associated with increased toxicity.


CONCLUSIONS
The addition of etoposide to the Bu/Cy regimen was well tolerated, but did not appear to improve the outcome.
Ayas
Mouhab
M
Department of Pediatric Hematology-Oncology, Section of Stem Cell Transplant, KFSHRC, Riyadh, Saudi Arabia. mouhab@kfshrc.edu.sa
Al-Seraihi
Amal
A
Al-Mahr
Mohamad
M
Al-Jefri
Abdullah
A
Belgaumi
Assim
A
Elhassan
Ibrahim
I
El-Solh
Hassan
H
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D016609:Neoplasms, Second Primary / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D005047:Etoposide; D003520:Cyclophosphamide; D002066:Busulfan