Cytarabine, melphalan, and total body irradiation as conditioning for autologous peripheral blood stem cell transplantation for patients with acute myeloid leukemia in first remission

Abstract

6687 Background: Current results of autologous peripheral blood stem cell transplantation (PBSCT) suggest that this procedure may prolong disease free survival in patients with acute myeloid leukemia (AML). Autologous PBSCT is increasingly used as the treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous PBSCT for the patients with AML in first remission, who were treated by autologous PBSCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen. Methods: Between January 1995 and July 2000, thirty-five patients with AML in first remission underwent autologous PBSCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine (3.0 gm/m2 for 3 days), melphalan (100 mg/m2 for 1 day) and TBI (total 1000 cGy in five fractions over 3 days). Results: The median follow up was 43 months with a range of 3 to 72 months. The 4-year cumulative probability of disease free survival was 64.2% and median survival was 40.3 months. The 4-year relapse rate was 32.9%. The factor influencing disease free survival and relapse rate was the French-American-British classification (M3 group vs. other groups; p=0.048, p=0.043). One patient died from treatment-related toxicity. Conclusions: Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBI as a conditioning regimen for autologous PBSCT for AML in first remission appears to be safe and effective, relatively. No significant financial relationships to disclose.