Bone marrow transplantation versus high-dose cytarabine-based consolidation chemotherapy for acute myelogenous leukemia in first remission

Gary J. Schiller, Stephen D. Nimer, Mary C. Territo, Winston G. Ho, Richard E. Champlin, James L. Gajewski

    Research output: Contribution to journalArticle

    61 Scopus citations

    Abstract

    Purpose: Despite substantial progress in the treatment of acute myeloid leukemia (AML), fewer than 25% of patients survive free of leukemia for more than 5 years without allogeneic bone marrow transplantation (BMT). In this study we analyzed the results of one or more cycles of high-dose cytarabine-based consolidation chemotherapy as compared with allogeneic BMT in first remission. Patients and Methods: The results in 28 adult patients, aged 16 to 45 years, who underwent a closely HLA-matched BMT for AML in first remission were compared with those in 54 consecutive, age-matched, adult patients treated with one or more cycles of high-dose, cytarabine-based consolidation chemotherapy. Results: After a median follow-up of 4 years, the actuarial risk of leukemic relapse was considerably lower in the transplant group than in the group treated with consolidation chemotherapy (32% ± 26% v 60% ± 14%; P = .05). Treatment-related mortality, however, was much higher in the group treated with BMT (32% v 6%, P = .002). The actuarial disease-free survival at 5 years was not significantly different for the two groups (45% ± 24% v 38% ± 14%). Conclusions: Our results show that BMT in first remission AML did not offer a disease-free survival advantage over intensive postremission consolidation chemotherapy. Larger studies are needed to identify patients who might benefit most from BMT.

    Original languageEnglish (US)
    Pages (from-to)41-46
    Number of pages6
    JournalJournal of Clinical Oncology
    Volume10
    Issue number1
    DOIs
    StatePublished - Jan 1 1992

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

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