Administration of amifostine in the stage of remission induction can benefit the patients with hematological malignancy in autologous stem cell transplantation: a retrospective study

Background: To investigate whether the administration of amifostine in the stage of remission induction can benefit patients with hematological malignancy in autologous stem cell transplantation (ASCT).

Methods: Two historical groups of patients who received prophylactic amifostine in the stage of remission induction and ASCT (group A, n=95) or amifostine in ASCT only (group B, n=73) were included. The chemotherapy-associated side effects in peripheral blood stem cell (PBSC) mobilization, total average monocyte per kilogram in stem cells collections, hematologic toxicity and engraftment kinetics, non-hematologic toxicity, therapeutic response after ASCT were compared between the two groups.

Results: For PBSCs mobilization, the rate of fever in group A was significantly higher (24/95 vs. 2/73; P=0.0001), but the incidence of emesis was significantly lower (8/95 vs. 27/73; P=0.0001) compared with group B. For collected PBSCs, the average total mononuclear cells per kilogram in group A were 7.031×10⁸/kg, while it was 4.624×10⁸/kg in group B (P=0.0001). The median duration of neutropenia was 8.62 days in group A, which was significantly shorter than that of group B by almost 2 days (10.51 days, P=0.038). The incidence of oral mucositis was 8.4% in group A and 32% in group B (P=0.0002). No significant differences of therapeutic response were observed between the two groups.

Conclusions: Prophylactic amifostine can reduce mucositis, improve monocytes collection and promote hematopoietic recovery in ASCT.