Abstract
While allogeneic stem cell transplantation (SCT) is curative for a significant number of patients with AML, relapse of disease within the bone marrow and/or extramedullary (EM) sites following high-dose therapy continues to limit the success of this treatment. Between October 1985 and December 1996, 81 adults underwent allogeneic SCT for de novo AML at our centre. Forty-two patients remain alive and free of leukaemia with a median follow-up of 50 months. The 5-year actuarial event-free survivals (EFS) for all patients and for those undergoing SCT in CR1 or with advanced disease were 46% (95% confidence interval (CI) 34-58%), 63% (CI 46-76%), and 19% (CI 7-36%), respectively. Twenty-two patients relapsed at a median of 8 (range 1.6-54.5) months with the actuarial risk of relapse for all, CR1 and advanced disease patients being 38 %, (CI 27-52%), 23% (CI 13-40%) and 68% (CI 46-88%), respectively. Ten patients relapsed at EM sites; six of these (27% of relapses) had an isolated EM relapse at a median of 31 (range 8.5-54) months. Three of the patients with isolated EM relapse survived ≤ 24 months following relapse and two patients remain disease-free at 29+ and 33+ months. BuCy conditioning followed by allogeneic SCT in AML results in satisfactory EFS although there is a significant risk of late isolated EM relapse.
Original language | English |
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Pages (from-to) | 259-264 |
Number of pages | 6 |
Journal | Bone Marrow Transplantation |
Volume | 22 |
Issue number | 3 |
DOIs | |
State | Published - 1998 |
Keywords
- Adolescent
- Adult
- Busulfan/administration & dosage
- Cyclophosphamide/administration & dosage
- Disease-Free Survival
- Female
- Graft vs Host Disease/etiology
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Immunosuppressive Agents/administration & dosage
- Leukemia, Myeloid, Acute/drug therapy
- Male
- Middle Aged
- Recurrence
- Transplantation Conditioning/adverse effects
- Transplantation, Homologous