TY - JOUR
TI - Comparison of allogeneic stem cell transplantation, high-dose
cytarabine, and autologous peripheral stem cell transplantation as
postremission treatment in patients with de novo acute myelogenous
leukemia
AU - Tsimberidou, AM
AU - Stavroyianni, N
AU - Viniou, N
AU - Papaioannou, M and
AU - Tiniakou, M
AU - Marinakis, T
AU - Skandali, A
AU - Sakellari, L and
AU - Yataganas, X
AU - Hellenic Cooperative Grp
JO - JMIR Cancer
PY - 2003
VL - 97
TODO - 7
SP - 1721-1731
PB - Wiley
SN - null
TODO - 10.1002/cncr.11240
TODO - de novo acute myelogenous leukemia (AML); postremission therapy;
allogeneic stem cell transplantation; autologous stem cell
transplantation; high-dose chemotherapy
TODO - BACKGROUND. Postremission therapy is critical in maintaining complete
remission (CR) in patients with de novo acute myelogenous leukemia
(AML). The aim of this trial was to compare allogeneic stem cell
transplantation (SCT), high-dose cytarabine (ara-C; HiDAC), and
autologous SCT as postremission therapy in patients with de novo AML.
METHODS. One hundred twenty patients age less than or equal to 60 years
with previously untreated AML (non-M3) and a performance status score of
less than or equal to 2 received induction therapy with 3 days of
idambicin and 7 days of ara-C (IA). Patients in CR received one course
of HiDAC. Subsequently, patients age ! 50 years with available
HLA-compatible donors were assigned to receive allogeneic SCT; patients
with “favorable” cytogenetics received a second course of HiDAC; and
all others were randomized to a second course of HiDAC or autologous
SCT.
RESULTS. The IA combination induced CR in 99 patients (82.5%). With a
median follow-up of 43 months (range, 18-64 years), the 3-year survival
and failure-free survival (FFS) rates were 47% and 45%, respectively.
The factors associated with longer survival were those identified for CR
(i.e., age and cvtogenetics). Forty-nine patients (49%) received the
assigned postremission therapy. Fifteen patients underwent allogeneic
SCT. Nineteen patients underwent autologous SCT and 15 patients received
a second course of HiDAC, after randomization. In the allogeneic SCT
group, both the 3-year survival and the FFS rates were 73%. In the
autologous SCT and HiDAC groups, the 3-year survival rates were 58% and
46%, respectively (P = 0.80), and the 3-year FFS rates were 42% and
33%, respectively (P = 0.83).
CONCLUSIONS. The three postremission treatment groups had comparable
survival. Allogeneic SCT is associated with a prolonged FFS.
ER -