Busulfan and melphalan as conditioning regimen for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission
Rev. bras. hematol. hemoter
;
33(3): 179-184, June 2011. ilus, tab
Article
Dans Anglais
| LILACS
| ID: lil-596318
ABSTRACT
BACKGROUND:
Allogeneic hematopoietic stem cell transplantation with HLA-identical donors has been established for the treatment of acute myeloid leukemia patients for over 30 years with a cure rate of 50 percent to 60 percent.OBJECTIVES:
To analyze the overall survival of patients and identify factors that influence the outcomes of this type of transplant in patients in 1st complete remission who received a busulfan and melphalan combination as conditioning regimen.METHODS:
Twenty-five consecutive patients with acute myeloid leukemia were enrolled between 2003 and 2008. The median age was 34 years old (Range 16 - 57 years). All patients received cyclosporine and methotrexate for prophylaxis against graft-versus-host disease. Median neutrophil engraftment time was 16 days (Range 7 - 22 days) and 17 days (Range 7 - 46 days) for platelets. Sinusoidal obstructive syndrome was observed in three patients, seven had grade II acute graft-versus-host disease and one extensive chronic graft-versus-host disease.RESULTS:
The overall survival by the Kaplan-Meier method was 48 percent after 36 months with a plateau at 36 months after transplantation. Intensive consolidation with high-dose arabinoside resulted in an improved survival (p-value = 0.0001), as did grade II acute graft-versus-host disease (p-value = 0.0377) and mild chronic graft-versus-host disease (p-value < 0.0001). Thirteen patients died, five due to infection within 100 days of transplant, two due to hemorrhages, one to infection and graftversus-host disease and three relapses followed by renal failure (one) and infection (two). The cause of death could not be determined for two patients.CONCLUSION:
The busulfan and melphalan conditioning regimen is as good as other conditioning regimens providing an excellent survival rate.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Induction de rémission
/
Busulfan
/
Leucémie aigüe myéloïde
/
Analyse de survie
/
Transplantation de cellules souches hématopoïétiques
/
Cyclophosphamide
/
Maladie du greffon contre l'hôte
/
Melphalan
Type d'étude:
Étude pronostique
Limites du sujet:
Adulte
/
Humains
langue:
Anglais
Texte intégral:
Rev. bras. hematol. hemoter
Thème du journal:
Hématologie
Année:
2011
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Universidade de São Paulo/BR
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