IDARUBICIN TO INTENSIFY THE CONDITIONING REGIMENS OF AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR PATIENTS WITH ACUTE MYELOID-LEUKEMIA IN FIRST COMPLETE REMISSION
S. Jerjis et al., IDARUBICIN TO INTENSIFY THE CONDITIONING REGIMENS OF AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR PATIENTS WITH ACUTE MYELOID-LEUKEMIA IN FIRST COMPLETE REMISSION, Bone marrow transplantation, 22(1), 1998, pp. 13-19
In an effort to reduce the relapse rate after unpurged autologous bone
marrow transplantation (ABMT) in patients with acute myeloid leukemia
(AML) in first complete remission (CR1), the, standard conditioning r
egimens (cyclophosphamide/busulphan and cyclophosphamide/TBI) were int
ensified by adding idarubicin, Seventeen patients received a continuou
s infusion of 21 mg idarubicin/m(2)/day for 2 consecutive days in addi
tion to the standard preparative regimen, Thirteen patients served as
a historical control group. The 2-year disease-free survival (DFS) of
82% in the study group was significantly (P = 0.047) better compared t
o 46% DFS in the control group. The relapse rate (RR) was also signifi
cantly lower (7% vs 45%; P = 0.035) in the study group. The median tim
e to reach a white cell count (WCC) of 0.5 x 10(9)/l was 20 days in th
e study group vs 17 days (P=NS) in the control group. The median time
until recovery of the platelet counts to 20 x 10(9)/l was 152 days in
the study group vs 57 days (P = NS) in the control group, The hypolasi
a in the study group resulted in a trend towards a higher need for tra
nsfusions: a median number of 38 units of erythrocytes vs 23 units in
the control group (P = NS) and 23 units of platelet vs 18 units in the
control group (P = NS), This pilot study suggests that addition of id
arubicin to the standard conditioning regimens may improve DFS and ove
rall survival (OS) of patients with AML treated with ABMT in CR1, Thes
e results should be confirmed in a prospective randomized study.