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Autologous stem cell transplantation for acute myeloid leukemia in first remission
Journal article   Open access

Autologous stem cell transplantation for acute myeloid leukemia in first remission

Charles A. Linker, Curt A. Ries, Lloyd E. Damon, Peter Sayre, Willis Navarro, Hope S. Rugo, Arnold Rubin, Delvyn Case, Pamela Crilley, David Topolsky, …
Biology of blood and marrow transplantation, v 6(1)
2000
PMID: 10707999
url
https://doi.org/10.1016/s1083-8791(00)70052-8View
Published, Version of Record (VoR)CC BY-NC-ND V4.0 Open
url
https://doi.org/10.1016/S1083-8791(00)70052-8View
Published, Version of Record (VoR) Open

Abstract

We studied the feasibility, toxicity, and efficacy of a 2-step approach to autologous stem cell transplantation for patients with acute myeloid leukemia in first remission. Step 1 consisted of consolidation chemotherapy including cytarabine 2000 mg/m2 twice daily for 4 days concurrent with etoposide 40 mg/kg by continuous infusion over 4 days. During the recovery from this chemotherapy, peripheral blood stem cells were collected under granulocyte colony-stimulating factor stimulation. Step 2, autologous stem cell transplantation, involved the preparative regimen of busulfan 16 mg/kg followed by etoposide 60 mg/kg and reinfusion of unpurged peripheral blood stem cells. A total of 128 patients were treated. During step 1, there was 1 treatment-related death. A median CD34+ cell dose of 14 (x10(6)/kg) was collected in 3 aphereses. Ten patients suffered relapse before transplantation, and 117 patients (91%) proceeded to transplantation. During step 2, there were 2 treatment-related deaths, and 35 patients subsequently suffered relapse. With median follow-up of 30 months, 5-year disease-free survival for all patients entered in the study is projected to be 55%. By cytogenetic risk group, 5-year disease-free survival is 73% for favorable-risk patients, 51% for intermediate-risk patients, and 0% for poor-risk patients. We conclude that this 2-step approach to autologous transplantation produces excellent stem cell yields and allows a high percentage of patients to receive the intended therapy. Preliminary efficacy analysis is very encouraging, with outcomes that appear superior to those of conventional chemotherapy. Biol Blood Marrow Transplant 2000;6(1):50-7.

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Collaboration types
Domestic collaboration
Web of Science research areas
Hematology
Immunology
Transplantation
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