TY - JOUR
T1 - 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, Apostolia Maria
AU - Stavroyianni, Niki
AU - Viniou, Nora
AU - Papaioannou, Maria
AU - Tiniakou, Maria
AU - Marinakis, Theodoros
AU - Skandali, Anastasia
AU - Sakellari, Ioanna
AU - Yataganas, Xenophon
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2003/4/1
Y1 - 2003/4/1
N2 - 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 ≤ 60 years with previously untreated AML (non-M3) and a performance status score of ≤ 2 received induction therapy with 3 days of idarubicin 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 cytogenetics). 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.
AB - 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 ≤ 60 years with previously untreated AML (non-M3) and a performance status score of ≤ 2 received induction therapy with 3 days of idarubicin 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 cytogenetics). 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.
KW - Allogeneic stem cell transplantation
KW - Autologous stem cell transplantation
KW - De novo acute myelogenous leukemia (AML)
KW - High-dose chemotherapy
KW - Postremission therapy
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U2 - 10.1002/cncr.11240
DO - 10.1002/cncr.11240
M3 - Article
C2 - 12655529
AN - SCOPUS:0037377715
SN - 0008-543X
VL - 97
SP - 1721
EP - 1731
JO - Cancer
JF - Cancer
IS - 7
ER -