AUTOLOGOUS VERSUS ALLOGENEIC MARROW TRANSPLANTATION FOR PATIENTS WITHACUTE MYELOID-LEUKEMIA IN 1ST REMISSION

Problem: In this trial the effectiveness and toxicity of autologous ma rrow transplant as a therapy of acute myeloid leukemia in 1st complete remission was evaluated by comparing it with allogeneic marrow transp lantation. Methods: Twenty-eight patients with AML in Ist CR underwent ABMT. A control group consists of 40 patients treated with BMT. There is no difference between the two group concerning the sex, FAB classi fication, WBC at diagnosis, and cytogenetics. Patients in ABMT were ol der (median 34 years vs median 27 years for BMT group p = 0.06). Inter val from CR to transplant is significantly longer for ABMT group (medi an 6 months for ABMT versus median 3 months for BMT group, p = 0.03). Median follow up is 52 months for ABMT and 108 months for BMT group. R esults: For conditioning Bu/Cy (predominantly for ABMT group) or TBI/C y (predominantly for BMT group) were used. A five-year probability of leukemia-free survival for ABMT group is 55% and for BMT is 68% (p = n .s.). A significantly higher probability of relapse was found in ABMT group (38% for ABMT vs 12% in BMT p = 0.02). In ABMT group the main ca use of death was relapse. In BMT group relapse, GVHD with or without i nfections were the principal causes of death. Conclusion: The results confirmed that autologous marrow transplant is effective postremission therapy for patients with AML younger than 50 years of age. Relapse r ate is a major problem.