No impact of high-dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission

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.