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Autologous or Allogeneic Bone Marrow Transplantation Compared with Consolidation Chemotherapy in Acute promyelocytic Leukemia / 대한암학회지
Journal of the Korean Cancer Association ; : 331-338, 1999.
Article in Korean | WPRIM | ID: wpr-96262
ABSTRACT

PURPOSE:

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myelogenous leukemia characterized by the morphology of blast cells (M3 in FAB classification), the t (15;17) translocation, and a coagulopathy combining disseminated intravascular coagulation and fibrinolysis. It has been considered to have better response to combination chemo- therapy of an anthracycline and cytosine arabinoside and a higher cure rate than other subtypes because of recent approach of differentiating leukemic blasts by all-transretinoic acid (ATRA). The role of stem cell transplantation in APL has to be determined in comparison with that of consolidation chemotherapy. MATERIALS AND

METHODS:

We compared the leukemia-free survival and overall survival between APL patients receiving the consolidation chemotherapy and those undergoing the allogeneic or autologous stem cell transplantation following the high-dose anticancer therapy. Of the 65 patients achieving the first complete remission from 1992 to 1997, 33 patients were treated with 3 courses of consolidation chemotherapies and 32 with the stem cell transplantation.

RESULTS:

With a median follow-up of 22 months (8-60), the actuarial leukemia-free survival at 3 years was significantly higher in transplantation group than in chematherapy group (73.8% versus 33.5%; P=0.0087), and the probability of leukemic relapse was considerably lower in transplantation group than in chemotherapy group (6.3% versus 57.5%; P=0.001). The treatment-related mortalities of the groups were 0% in chemotherapy group and 14.3% in transplantation group. The main cause of deaths was relapse in the consolidation chemotherapy group.

CONCLUSION:

These data demonstrate that the stem cell transplantation results in better leukemia-free survival than the consolidation chemotherapy for patients with APL in the first complete remission because of lower risk of relapse.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Recurrence / Bone Marrow / Leukemia, Myeloid, Acute / Leukemia, Promyelocytic, Acute / Follow-Up Studies / Mortality / Cause of Death / Bone Marrow Transplantation / Cytarabine / Stem Cell Transplantation Type of study: Observational study / Prognostic study Limits: Humans Language: Korean Journal: Journal of the Korean Cancer Association Year: 1999 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Recurrence / Bone Marrow / Leukemia, Myeloid, Acute / Leukemia, Promyelocytic, Acute / Follow-Up Studies / Mortality / Cause of Death / Bone Marrow Transplantation / Cytarabine / Stem Cell Transplantation Type of study: Observational study / Prognostic study Limits: Humans Language: Korean Journal: Journal of the Korean Cancer Association Year: 1999 Type: Article