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ctt-journal > Moiseev et al. (Abstract)

Moiseev et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract71

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Sequential high-dose chemotherapy followed by reduced-intensity conditioning for allogeneic hematopoietic stem cell transplantation in patients with acute leukemia in progression

Ivan S. Moiseev, Vladimir N. Vavilov, Nina E. Osipova, Irina K. Golubovskaya, Elena I. Darskaya, Boris V. Afanasyev

R.M. Gorbacheva Memorial Institute of Pediatric Hematology and Transplantation, St. Petersburg Pavlov State Medical University, St. Petersburg, Russia

Correspondence: Ivan S. Moiseev, R.M. Gorbacheva Memorial Institute of Pediatric Hematology and Transplantation, St. Petersburg Pavlov State Medical University, 6/8, Tolstoy str., St. Petersburg, 197022, Russia, E-mail: moisiv@spam is badmail.ru

Abstract

Aim: To improve the results of allogeneic hematopoietic stem cell transplantation in patients with progression of acute leukemia by using sequential high-dose chemotherapy and a busulfan-containing reduced intensity conditioning (RIC) regimen.

Methods: To date 6 patients with acute myeloid leukemia and 1 patient with acute lymphoblastic leukemia were included in a prospective study. All patients failed several lines of induction chemotherapy or had transformation from myelodysplastic syndrome. The conditioning regimen consisted of cytarabine (2 g/m2), fludarabine (30 mg/m2), daunorubicin (20 mg/m2) at days -11 to -8, and busulfan (4 mg/kg) days -4 to -3 and fludarabine (30 mg/m2) days -3 to -2. All patients were transplanted from unrelated donors. GVHD prophylaxis consisted of ATG, tacrolimus, and methotrexate or MMF.

Results: The suggested conditioning regimen was generally well tolerated. Eighty-six percent of patients successfully engrafted (at median 17 days). Median agranulocytosis duration was 26 days. Febrile neutropenia developed in 86% of patients. Grade 3–4 toxicity (based on NCI CTC criteria) included mucositis in 57% of patients, and one patient developed severe veno-occlusive disease. Complete remission was achieved in 71% of patients. Survival at 100 days was 57%. One patient had primary graft failure and died of disease progression, 1 died of sepsis after engraftment, and 1 died of grade 4 intestinal aGVHD.

Conclusions: Results with this new RIC regimen seem to be promising in treatment of chemo-resistant patients with acute leukemia.

Keywords: Chemo-resistant acute leukemia, hematopoietic stem cell transplantation, reduced-intensity conditioning