High-dose melphalan with or without stem cell support before myeloablative allo-SCT for remission induction in patients with advanced relapsed or refractory AML.

Details

Serval ID
serval:BIB_6C81A77E3C9E
Type
Article: article from journal or magazin.
Collection
Publications
Title
High-dose melphalan with or without stem cell support before myeloablative allo-SCT for remission induction in patients with advanced relapsed or refractory AML.
Journal
Bone marrow transplantation
Author(s)
O'Meara A., Pabst T., Heim D., Gerull S., Bucher C., Halter J., Arber C., Rovò A., Tichelli A., Gratwohl A., Stern M.
ISSN
1476-5365 (Electronic)
ISSN-L
0268-3369
Publication state
Published
Issued date
05/2011
Peer-reviewed
Oui
Volume
46
Number
5
Pages
636-640
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Treatment strategies for relapsed/refractory AML are limited and disappointing. Recently, high-dose melphalan (HDM) chemotherapy and autologous hematopoietic SCT (HSCT) has been proposed for AML re-induction. We investigated the impact of HDM remission induction in highly advanced relapsed/refractory AML patients planned for allogeneic HSCT. A total of 23 patients with relapsed/refractory AML were prospectively scheduled for HDM with or without stem cell support followed by myeloablative allogeneic HSCT. Patients included nine individuals with a history of previous HSCT (seven allogeneic, two autologous). A total of 18 patients (78%) achieved a leukemia-free state and an additional four had substantial reduction of the initial leukemia burden warranting treatment continuation. There were no differences between patients with or without immediate stem cell support regarding mucositis or other organ toxicity. A total of 20 patients proceeded to myeloablative allogeneic HSCT. Outcome of allogeneic HSCT was poor: 11 patients (55%) relapsed, 7 patients (35%) died from TRM and only 2 patients (10%) were alive at the last follow-up. Our study shows that HDM is effective in inducing a leukemia-free state in patients with highly advanced relapsed/refractory AML. Leukemia burden reduction with HDM, however, did not translate into improved OS.
Keywords
Adult, Aged, Female, Hematopoietic Stem Cell Transplantation/adverse effects, Hematopoietic Stem Cells/drug effects, Humans, Leukemia, Myeloid, Acute/therapy, Male, Melphalan/administration & dosage, Melphalan/adverse effects, Middle Aged, Myeloablative Agonists/therapeutic use, Recurrence, Remission Induction/methods, Transplantation Conditioning/methods, Transplantation, Autologous, Treatment Outcome
Pubmed
Web of science
Open Access
Yes
Create date
01/11/2019 11:08
Last modification date
02/11/2019 7:26
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