Jy. Cahn et al., No impact of high-dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission, BR J HAEM, 110(2), 2000, pp. 308-314
High-dose cytarabine is currently used in combination with anthracycline in
the treatment of acute myeloblastic leukaemia (AML). Moreover, high-dose c
ytarabine has been reported to produce long-term disease-free survival in a
proportion of patients, especially in certain subtypes of AML. However, it
remains unknown whether the outcome of patients undergoing allogeneic or a
utologous stern cell transplantation is influenced by previous treatment wi
th high-dose cytarabine. To this end, 1672 patients with AML in first remis
sion who were reported to the Acute Leukaemia Working Party registry of the
European Group for Blood and Marrow Transplantation (EBMT) and who were tr
ansplanted between 1980 and 1995 were analysed according to the dose intens
ity of cytarabine given at induction and/or consolidation. Autologous stem
cell transplantation (ABMT) was performed in 846 patients and allogeneic bo
ne marrow transplantation (BMT) in 826 patients. This study shows that the
dose of cytarabine (Ara-C) given at induction and/or consolidation did not
influence the relapse incidence in patients subsequently allografted or aut
ografted. Tn addition, it did not give any advantage in terms of overall ou
tcome. Therefore, high-dose (HD) Ara-C may not be needed for patients who h
ave a planned stem cell transplantation (SCT) as post-remission therapy. Ne
vertheless, HD Ara-C may be utilized in certain subtypes of AML that are be
lieved to be curable by chemotherapy alone.