Autologous hematopoietic stem cell transplantation for adults with acute myeloid leukemia in complete remission: the Edouard Herriot Hospital experience

Hematology. 2006 Jun;11(3):157-64. doi: 10.1080/10245330600702794.

Abstract

We retrospectively assess the long-term outcome and determined prognostic factors correlated with outcomes in adults with acute myeloid leukemia (AML) undergoing autologous hematopoietic stem cell transplantation (HSCT) in our institution over a 19-year period. A total of 78 adults who received autologous HSCT for AML in first complete remission (CR) and of 21 adults in further CR were included in the study. Bone marrow (n = 14) or peripheral blood stem cells (PBSC) (n = 85) transplantation was performed at a median of 2.9 months from CR. Hematologic recovery was significantly reduced in the PBSC group. Five-year cumulative incidences of relapse were 56 and 49%, respectively. Corresponding 5-year probabilities of event-free survival (EFS) were 33 and 35%, while those of overall survival (OS) were 38 and 49%, respectively. In multivariate analyses, cytogenetics was the main prognostic factor for outcome. Treatment-related mortality (TRM) was of 15% at 5 years, but higher in females as compared to males (p = 0.04). We confirmed that long-term EFS can be achieved after autologous HSCT in adult patients with AML. Results in adults who experience a relapse after conventional chemotherapy support the use of autologous HSCT as salvage therapy if such patients achieve a subsequent CR.

MeSH terms

  • Acute Disease
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Transplantation / mortality
  • Bone Marrow Transplantation / statistics & numerical data*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Leukemia, Myeloid / drug therapy
  • Leukemia, Myeloid / epidemiology
  • Leukemia, Myeloid / mortality
  • Leukemia, Myeloid / surgery*
  • Male
  • Middle Aged
  • Peripheral Blood Stem Cell Transplantation / mortality
  • Peripheral Blood Stem Cell Transplantation / statistics & numerical data*
  • Recurrence
  • Remission Induction
  • Retrospective Studies
  • Salvage Therapy*
  • Transplantation Conditioning / adverse effects
  • Transplantation, Autologous
  • Treatment Outcome