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Kruchkova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract29
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Autologous stem cell transplantation (ASCT) for acute myeloid leukemia (AML): A 10-year single centre experience

Irina V. Kruchkova, Vera V. Sergeevicheva, Daria S. Baranova, Galina Yu. Ushakova, Alexander D. Kulagin, Svetlana A. Sizikova, Igor A. Lisukov, Andrey V. Gilevich, Vladimir A. Kozlov

Institute of Clinical Immunology SB RAMS, Novosibirsk, Russia

Correspondence: Irina V. Kruchkova, Institute of Clinical Immunology SB RAMS, 14, Yadrintsevskaya, 630099, Novosibirsk, Russia, E-mail: bmt-novosibirsk@spam is badmail.ru

Abstract

The role of ASCT for AML consolidation remains controversial.  

Aim of the study: A retrospective analysis of ASCT for AML results in the Novosibirsk Institute of Clinical Immunology. 

Patients and methods: From 1999 to 2009 37 patients at the median age of 27 years (range 10–55) underwent ASCT; 31/37 were in first remission (CR1), and 6 were >CR1 at the time of ASCT. Peripheral blood was used as the stem cell source in all but 4 cases.  The median dose of CD34+ cells infused was 4.9x10*6/kg (range 1.2–17.0). The conditioning regimens were Bu16/Cy120 in 17 patients and high dose melphalan (HDMel) 160–200 mg/m2 in 20 patients.

Results: The median time of granulocyte and platelet recovery was 27 and 53 days respectively in patients after Bu/Cy. At the same time the median period of crucial neutropenia and thrombocytopenia after HDMel was much shorter (12 and 15 days respectively, p=0.01). Two patients failed to engraft and died after ASCT from sepsis. Mucosal toxicity at grade 3–4 was observed in 9/37 patients, sepsis in 7 patients, and pneumonia in 2 patients. There were 2 cases of VOD and 4 cases of hemorrhagic cystitis. We observed most of these severe complications (83%) in patients after Bu/Cy. The transplant-related mortality was 5% and cause of death was sepsis. OS after transplantation was 50% at 3 years and 39% at 5 years (Fig. 1) Seventeen patients relapsed in the first year and 2 patients developed relapse at 27 and 35 months after ASCT. Currently 15 patients are alive in CR.

Figure 1.

Conclusions: The long-term follow-up data confirms that ASCT is a feasible and encouraging consolidation therapy for AML. Conditioning regimens with Bu/Cy and HDMel provide the same DFS and OS, while HDMel is associated with lower toxicity rates. 

Keywords: acute myeloid leukemia, autologous stem cell transplantation

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