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High-dose chemotherapy and autologous bone marrow transplantation in acute
myeloid leukemia
AK McMillan, AH Goldstone, DC Linch, JG Gribben, KG Patterson, JD Richards, I Franklin, BJ Boughton, DW Milligan and MM Leyland
University College and Middlesex Schools of Medicine, Leicester, UK.
For younger patients with acute myeloid leukemia (AML), an allogeneic
transplant from a matched sibling may afford the best chance of cure. In
patients who are older or without a matched sibling donor, dose
intensification can be achieved with an autologous bone marrow transplant
(ABMT). We report here the results of a high-dose chemotherapy regime with
nonpurged ABMT in 82 adult patients in first remission of AML with a median
follow-up of 31 months. The median age was 40 years (range 16 to 57 years).
The median interval between remission and ABMT was 5 months (range 1 to 12
months). Twenty-eight of these patients received a second course of the
same high-dose chemotherapy and ABMT. The procedure related mortality rate
was 6%. The projected leukemia-free survival (LFS) at 5 years is 48% for
all 82 patients and 50% for the 76 patients with no known preceding
myelodysplastic syndrome. For those patients with primary AML who received
a double ABMT the projected LFS is 67%. The interval between remission and
ABMT did not predict for either relapse or LFS. ABMT using a multidrug
chemotherapy protocol is less toxic than allogeneic BMT yet results in a
similar LFS.
Volume 76,
Issue 3,
pp. 480-488,
08/01/1990
Copyright © 1990 by The American Society of Hematology
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