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Blood, 1 August 2006, Vol. 108, No. 3, pp. 1092-1099. Prepublished online as a Blood First Edition Paper on March 21, 2006; DOI 10.1182/blood-2005-10-4165. This Article Full Text (PDF) All Versions of this Article: 2005-10-4165v1 108/3/1092    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Schmid, C. Articles by Kolb, H.-J. Search for Related Content PubMed PubMed Citation Articles by Schmid, C. Articles by Kolb, H.-J. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 19, 2005 Accepted March 3, 2006 Long term survival in refractory acute myeloid leukemia after sequential treatment with chemotherapy and reduced intensity conditioning for allogeneic stem cell transplantation Christoph Schmid*, Michael Schleuning, Rainer Schwerdtfeger, Bernd Hertenstein, Eva Mischak-Weissinger, Donald Bunjes, Stephanie v. Harsdorf, Christoph Scheid, Udo Holtick, Hildegard Greinix, Felix Keil, Barbara Schneider, Michael Sandherr, Gesine Bug, Johanna Tischer, Georg Ledderose, Michael Hallek, Wolfgang Hiddemann, and Hans-Jochem Kolb Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Munich, Germany; Clinical Cooperative Groups 'Stem Cell Transplantation', GSF Research Center for Environment and Health, Munich, Germany; Department of Medicine II, Klinikum Augsburg, Augsburg, Germany BMT-Unit, Deutsche Klinik fur Diagnostik, Wiesbaden, Germany Department of Hematology/Oncology, Medizinische Hochschule Hannover, Hannover, Germany Department of Medicine III, University of Ulm, Ulm, Germany Department of Medicine I, University of Cologne, Cologne, Germany Department of Medicine I, Medical University of Vienna, Vienna, Austria Core Unit for Medical Statistics and Informatics, Section of Medical Statistics, University of Vienna, Vienna, Austria Department of Medicine II, Klinikum Augsburg, Augsburg, Germany Department of Medicine II, University of Frankfurt, Frankfurt, Germany Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Munich, Germany Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Munich, Germany; Acute Leukemia, GSF Research Center for Environment and Health, Munich, Germany Department of Internal Medicine III, Ludwig-Maximilians-University of Munich, Munich, Germany; Clinical Cooperative Groups 'Stem Cell Transplantation', GSF Research Center for Environment and Health, Munich, Germany * Corresponding author; email: Schmid_Christoph{at}2med.zk.augsburg-med.de. A sequential regimen of chemotherapy, reduced-intensity conditioning (RIC) for allogeneic SCT, and prophylactic donor lymphocyte transfusion (pDLT) was studied in 103 patients with refractory acute myeloid leukemia (AML). According to published criteria, refractoriness was defined by primary induction failure (PIF, n=37), early (n=53), refractory (n=8) or second (n=5) relapse. Chemotherapy consisted of fludarabine (4x30mg/m2), cytarabine (4x2g/m2), and amsacrine (4x100mg/m2), followed four days later by RIC, comprizing 4Gy TBI, cyclophosphamide, and antithymocyte globulin. Patients without GvHD at day +120 received pDLT in escalating doses. Patients median age was 51.8 years. Before conditioning, 99 patients had active disease, three were aplastic, one in CR2. Forty-one patients had family, 62 had unrelated donors. With a 25-months median follow-up, overall survival (OS) at 1, 2, and 4 years was 54%, 40% and 32%, the respective leukemia-free survival (LFS) was 47%, 37% and 30%. Patients with PIF showed a 2-year-OS of 62.5%. OS was 87% in 17 patients receiving pDLT. One-year cumulative incidence of leukemic death and non-relapse-mortality was 28.7% and 17.2%. In a multivariate analysis, >2 courses of prior chemotherapy were the strongest predictor for poor outcome (p=0.007,HR=3.01 (OS), p=0.002,HR=3.25 (LFS)). These results indicate a high activity of the regimen in refractory AML. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Metzelder, Y. Wang, E. Wollmer, M. Wanzel, S. Teichler, A. Chaturvedi, M. Eilers, E. Enghofer, A. Neubauer, and A. Burchert Compassionate use of sorafenib in FLT3-ITD-positive acute myeloid leukemia: sustained regression before and after allogeneic stem cell transplantation Blood, June 25, 2009; 113(26): 6567 - 6571. [Abstract] [Full Text] [PDF] J. Krauter, K. Wagner, I. Schafer, R. Marschalek, C. Meyer, G. Heil, M. Schaich, G. Ehninger, D. 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