Disease-free survival after autologous bone marrow transplantation in patients with acute myelogenous leukemia

Blood ◽  
1989 ◽  
Vol 74 (6) ◽  
pp. 1898-1904 ◽  
Author(s):  
M Korbling ◽  
W Hunstein ◽  
TM Fliedner ◽  
S Cayeux ◽  
B Dorken ◽  
...  
Keyword(s):  
High Risk ◽  
Autologous Bone Marrow Transplantation ◽  
Disease Free Survival ◽  
Autologous Bone Marrow ◽  
Myelogenous Leukemia ◽  
Free Survival ◽  
Acute Myelogenous ◽  
Autologous Bone ◽  
Disease Free

Abstract Autologous bone marrow transplantation (ABMT) makes it possible to escalate the dose of cytotoxic treatment to a lethal range. Disease- free survival (DFS) following myeloablative therapy and ABMT has been shown to be superior to conventional treatment in high risk patients with acute myelogenous leukemia (AML). It was the purpose of the present study to compare hematopoietic reconstitution, actuarial DFS, and relapse rate of patients transplanted in first complete remission (CR) of AML with those in second or subsequent CR, and to evaluate transplant related mortality. Fifty-two patients with AML, 22 in first CR (low risk) and 30 in second or subsequent CR (high risk), underwent total body irradiation (12.1 to 16.7 Gy) and cyclophosphamide (CY) treatment (200 mg/kg) followed by ABMT. The autograft was incubated with the active CY derivative Mafosfamide (ASTA Werke, Bielefeld, Federal Republic of Germany) to reduce the number of possibly contaminating clonogenic tumor cells. All patients showed three lineage engraftments with platelet recovery observed as being the slowest. The transplant related death rate was low at 5.8%. There was no significant difference in the kinetics of polymorphonuclear (PMN) cell or platelet reconstitution between the low and high risk patient subgroups. The estimated probability of DFS (relapse) after ABMT in first CR was 61% (36%) compared with 34% (65%) in second or subsequent CR, the longest follow-up being 55 months and 57 months, respectively (median follow-up 31 months and 19 months, respectively). ABMT offers a stable long-term DFS when performed in first CR with no relapses occurring in over a year after transplantation. Six later relapses, however, were seen after ABMT in second or subsequent CR, although DFS was not statistically different from that of first remission patients (P = .72).

scholarly journals Disease-free survival after autologous bone marrow transplantation in patients with acute myelogenous leukemia

Blood ◽  
1989 ◽  
Vol 74 (6) ◽  
pp. 1898-1904 ◽  
Author(s):  
M Korbling ◽  
W Hunstein ◽  
TM Fliedner ◽  
S Cayeux ◽  
B Dorken ◽  
...  
Keyword(s):  
High Risk ◽  
Autologous Bone Marrow Transplantation ◽  
Disease Free Survival ◽  
Autologous Bone Marrow ◽  
Myelogenous Leukemia ◽  
Free Survival ◽  
Acute Myelogenous ◽  
Autologous Bone ◽  
Disease Free

Autologous bone marrow transplantation (ABMT) makes it possible to escalate the dose of cytotoxic treatment to a lethal range. Disease- free survival (DFS) following myeloablative therapy and ABMT has been shown to be superior to conventional treatment in high risk patients with acute myelogenous leukemia (AML). It was the purpose of the present study to compare hematopoietic reconstitution, actuarial DFS, and relapse rate of patients transplanted in first complete remission (CR) of AML with those in second or subsequent CR, and to evaluate transplant related mortality. Fifty-two patients with AML, 22 in first CR (low risk) and 30 in second or subsequent CR (high risk), underwent total body irradiation (12.1 to 16.7 Gy) and cyclophosphamide (CY) treatment (200 mg/kg) followed by ABMT. The autograft was incubated with the active CY derivative Mafosfamide (ASTA Werke, Bielefeld, Federal Republic of Germany) to reduce the number of possibly contaminating clonogenic tumor cells. All patients showed three lineage engraftments with platelet recovery observed as being the slowest. The transplant related death rate was low at 5.8%. There was no significant difference in the kinetics of polymorphonuclear (PMN) cell or platelet reconstitution between the low and high risk patient subgroups. The estimated probability of DFS (relapse) after ABMT in first CR was 61% (36%) compared with 34% (65%) in second or subsequent CR, the longest follow-up being 55 months and 57 months, respectively (median follow-up 31 months and 19 months, respectively). ABMT offers a stable long-term DFS when performed in first CR with no relapses occurring in over a year after transplantation. Six later relapses, however, were seen after ABMT in second or subsequent CR, although DFS was not statistically different from that of first remission patients (P = .72).

scholarly journals BAVC regimen and autologous bone marrow transplantation in patients with acute myelogenous leukemia in second remission

Blood ◽  
1990 ◽  
Vol 75 (12) ◽  
pp. 2282-2285 ◽  
Author(s):  
G Meloni ◽  
P De Fabritiis ◽  
MC Petti ◽  
F Mandelli
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Autologous Bone Marrow Transplantation ◽  
Conditioning Regimen ◽  
Disease Free Survival ◽  
Autologous Bone Marrow ◽  
Myelogenous Leukemia ◽  
Free Survival ◽  
Acute Myelogenous ◽  
First Remission

Abstract Twenty-one acute myelogenous leukemia (AML) patients were submitted in second remission (II CR) to BAVC conditioning regimen followed by unpurged ABMT. Transplant was done after a median of 2 months from II CR (range, 1 to 13). Median first remission (I CR) duration was 16 months (range, 1–35). Conditioning regimen was well tolerated, with no major extra-medullary toxicity. One patient died during aplasia from fungal sepsis. Of the 20 evaluable patients, nine relapsed after a median time of 6 months (range, 2 to 18). Eleven patients are in continuous complete remission (CCR) after a median follow-up of 40 months (range, 24 to 63). The duration of II CR has exceeded the duration of I CR in all patients in CCR. Projected probability of disease-free survival is 52% at 63 months.

scholarly journals BAVC regimen and autologous bone marrow transplantation in patients with acute myelogenous leukemia in second remission

Blood ◽  
1990 ◽  
Vol 75 (12) ◽  
pp. 2282-2285 ◽  
Author(s):  
G Meloni ◽  
P De Fabritiis ◽  
MC Petti ◽  
F Mandelli
Keyword(s):  
Acute Myelogenous Leukemia ◽  
Autologous Bone Marrow Transplantation ◽  
Conditioning Regimen ◽  
Disease Free Survival ◽  
Autologous Bone Marrow ◽  
Myelogenous Leukemia ◽  
Free Survival ◽  
Acute Myelogenous ◽  
First Remission

Twenty-one acute myelogenous leukemia (AML) patients were submitted in second remission (II CR) to BAVC conditioning regimen followed by unpurged ABMT. Transplant was done after a median of 2 months from II CR (range, 1 to 13). Median first remission (I CR) duration was 16 months (range, 1–35). Conditioning regimen was well tolerated, with no major extra-medullary toxicity. One patient died during aplasia from fungal sepsis. Of the 20 evaluable patients, nine relapsed after a median time of 6 months (range, 2 to 18). Eleven patients are in continuous complete remission (CCR) after a median follow-up of 40 months (range, 24 to 63). The duration of II CR has exceeded the duration of I CR in all patients in CCR. Projected probability of disease-free survival is 52% at 63 months.

Timed sequential chemotherapy for previously treated patients with acute myeloid leukemia: long-term follow-up of the etoposide, mitoxantrone, and cytarabine-86 trial.

1995 ◽  
Vol 13 (1) ◽  
pp. 11-18 ◽  
Author(s):  
E Archimbaud ◽  
X Thomas ◽  
V Leblond ◽  
M Michallet ◽  
P Fenaux ◽  
...  
Keyword(s):  
Autologous Bone Marrow Transplantation ◽  
Disease Free Survival ◽  
Autologous Bone Marrow ◽  
Myelogenous Leukemia ◽  
Sequential Chemotherapy ◽  
Long Term Follow Up ◽  
Acute Myelogenous ◽  
First Relapse ◽  
Previously Treated

PURPOSE To confirm and extend encouraging preliminary results of timed sequential chemotherapy (TSC) in patients with previously treated acute myelogenous leukemia (AML). PATIENTS AND METHODS We report the results of the regimen of mitoxantrone on days 1 to 3, etoposide on days 8 to 10, and cytarabine on days 1 to 3 and 8 to 10 (EMA) in 133 patients, with a median follow-up of 40 months. RESULTS Sixty percent of patients, with a 95% confidence interval (CI) ranging from 51% to 68%, achieved complete remission (CR), including 44% (CI, 32% to 57%) of refractory patients and 76% (CI, 64% to 86%) of late first-relapse patients (P = .0002). Twenty-nine percent of patients did not respond to therapy, and 11% died from toxicity. Median duration of neutropenia and thrombocytopenia was 31 days and 29 days, respectively. Severe nonhematologic toxicity included sepsis in 54% of patients and mucositis in 23%. Postinduction therapy included a second course of EMA in 27 patients, maintenance in 10, autologous bone marrow transplantation (BMT) in 12, and allogeneic BMT in 13. Median survival of patients who did not have transplantation performed is 7 months, with 11% (CI, 4% to 18%) survival at 5 years. Median disease-free survival (DFS) is 8 months with 20% (CI, 8% to 32%) DFS at 5 years. Twenty-eight percent (CI, 15% to 44%) of nontransplanted patients who achieved CR had an inversion of CR duration. Previous refractoriness was the main factor associated with poor prognosis for CR achievement, DFS, and survival. CONCLUSION These results confirm initial reports on TSC and show that approximately 20% of patients with first relapse after therapy can enjoy prolonged DFS using chemotherapy only.

Autologous bone marrow transplantation for patients with poor-prognosis lymphoma.

1988 ◽  
Vol 6 (8) ◽  
pp. 1303-1313 ◽  
Author(s):  
S C Gulati ◽  
B Shank ◽  
P Black ◽  
J Yopp ◽  
B Koziner ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Combination Chemotherapy ◽  
Poor Prognosis ◽  
Autologous Bone Marrow Transplantation ◽  
Disease Free Survival ◽  
Autologous Bone Marrow ◽  
Free Survival ◽  
Autologous Bone ◽  
Disease Free

Review of prognostic factors at Memorial Hospital in New York City has shown that adult patients with large-cell lymphoma (diffuse histiocytic lymphoma by Rappaport classification) who have high lactic dehydrogenase (LDH) and/or bulky mediastinal or abdominal disease are destined to do poorly with conventional combination chemotherapy, with a 2-year disease-free survival of about 20%. Patients who relapse after conventional combination chemotherapy have a similar poor prognosis. Thirty-one such patients with lymphoma were studied to evaluate the efficacy of intensive radiotherapy (hyperfractionated total body irradiation [TBI] [1,320 rad]), and cyclophosphamide (60 mg/kg/d for two days) followed by autologous bone marrow transplantation (ABMT). Our results show a disease-free survival advantage (P = .002) for 14 patients who underwent ABMT immediately after induction of remission with 79% surviving at a median follow-up 49.2+ months, compared with a median survival of 5.2 months for 17 patients administered ABMT while in relapse and/or after failing conventional treatment. Our results support the use of aggressive therapy as early treatment for patients with poor prognostic features.

Sign in / Sign up

Export Citation Format

Share Document