Autologous blood cell vs marrow transplantation for acute myeloid leukemiain complete remission: an EBMT retrospective analysis

In order to compare autologous bone marrow (BMT) and blood cell transplanta tion (BCT) in patients with acute myeloid leukemia (AML) in first remission (CRI), me retrospectively reviewed the data of 1393 patients registered to EBMT and undergoing either BCT (n = 100), purged (n = 252) or unpurged (n = 1041) BMT. Hematopoietic recovery was significantly quicker after BCT tha n after either purged or unpurged BRIT, The 2-year leukemia-free survival ( LFS), relapse incidence (RT) and overall survival for the entire population of patients were 52 +/- 1%, 43 +/- 1% and 58 +/- 1% and were significantly influenced by FAB subtype (M3 vs other) and the intervals between diagnosi s and CR1 or CR1 and transplant. After BCT, LFS and RI were 44 +/- 6% and 5 0 +/- 6% and did not differ significantly from that found for unpurged BRIT (49+/-2% and 45+/-2%; P = NS), However, LFS (57 +/- 3%) and RI (37 +/- 3%) of patients undergoing purged BRIT were significantly different from that found for BCT patients (P = 0.01 and P = 0.006). As some characteristics of patients undergoing BCT or purged BRIT differed significantly (age, interv als between diagnosis and CR1 or CR1 and transplant), the better outcome ob served for purged BRIT over BCT patients needs to be prospectively investig ated.