AUTOLOGOUS BONE-MARROW TRANSPLANTATION FOR ACUTE MYELOID-LEUKEMIA USING 4-HYDROPEROXYCYCLOPHOSPHAMIDE-PURGED BONE-MARROW AND THE BUSULFAN ETOPOSIDE PREPARATIVE REGIMEN - A FOLLOW-UP REPORT/

We studied the use of autologous bone marrow transplantation (ABMT) as treatment for acute myeloid leukemia (AML) in adults up to age 60, We used a preparative regimen of busulfan 16 mg/kg plus etoposide 60 mg/ kg and bone marrow purged with 100 mu g/ml of 4-hydroperoxycyclophosph amide (4HC). We treated 50 first remission patients; there were two tr eatment-related deaths and 13 relapses. With median follow-up of 6.8 y ears (minimum 4.5) disease-free survival (DFS) is 70%, relapse rate 27 % and overall survival 72%. Patients with favorable cytogenetics had D FS 78% and relapse 18% whereas unfavorable patients had DFS 63% and re lapse rate 35%. For 25 patients in second or third remission there wer e five treatment-related deaths and seven relapses. DFS is 52% and rel apse rate 35%. None of six patients with primary refractory AML had lo ng-term disease control. These data support the use of ABMT with an in tensive preparative regimen and purged bone marrow as a highly effecti ve treatment for adults with AML.