AML-259: Autologous Stem Cell Transplantation in Patients with Acute Myeloid Leukemia: Single Center Experience

Abstract

Context Acute myeloid leukemia (AML) is a hematological malignant disease that motivates the persistent struggle in the scientific world to provide effective cure. Objective The main goal of this analysis was to see if autologous stem cell transplantation (SCT) with myeloablative conditioning is still a powerful weapon that can be used against AML, providing acceptable safety and survival rates. Design We have evaluated retrospectively patients with AML where autologous SCT was performed in the period from 2000 till 2018. Evaluated the OS and transplant related mortality (TRM) as main objectives. Setting All patients were transplanted in the Bone Marrow Transplant unit in the University Clinic for Hematology Skopje. Underwent standard posttransplant preventive and prophylactic measures during the period of pancytopenia. Patients or other participants We have done a retrospective analysis of patients with AML where autologous SCT was done. The main inclusion criterion was the diagnosis, achieved complete remission with standard chemotherapy protocols and acceptable EBMT risk score. Interventions In all patients, first mobilizing and harvesting of stem cells was performed, and cryopreserved afterwards. Myeloablative conditioning was used, and application of the thawed graft done via central venous catheter. Main outcome measures We mainly evaluated the rates of overall survival (OS) and transplant related mortality (TRM). Results We have evaluated retrospectively patients with AML where autologous SCT was performed in the period from 2000 till 2018. Our group consisted of 94 patients: 45 male patients, 49 female patients. Median age at diagnosis was 44 years. In the majority of our group, we used myeloablative conditioning regimen with busulphan-cyclophosphamide, 60 patients. As auto graft we used peripheral blood stem cells (PBSC) in 78 patients, and in 16 patients we used bone marrow. The main mobilising regimen for PBSC was G-CSF + etoposide, which was performed in 44 patients. The transplant related mortality (TRM) was 2.1 %. The 5-year overall survival of our patients was 46.7 patients. The main reason for death was relapse of the primary disease (73%). Conclusions Autologous stem cell transplantation could be an acceptable therapeutic solution for patients with AML as a consolidation therapy.