In:
American Journal of Hematology, Wiley, Vol. 82, No. 1 ( 2007-01), p. 6-14
Abstract:
Limited data are available for adults undergoing unrelated donor (URD) BMT for AML using chemotherapy‐only preparative regimens. Previous studies incorporated irradiation, included adults and children, and excluded secondary leukemia. Herein we report long‐term outcomes for adults with poor‐prognostic AML receiving a novel regimen of busulfan (16 mg/kg), cytarabine (8,000 mg/m 2 ), and cyclophosphamide (120 mg/kg) (BAC), followed by URD BMT. From June 1995 through October 2001, 45 adults were enrolled. Adverse features included unfavorable cytogenetics (49%), secondary AML (47%), leukemia at transplant (42%), and extramedullary disease (16%). At time of BMT, 23 were in remission (12 CR1) while 22 had leukemia. Four (9%) died early. Acute and chronic GVHD rates were 44 and 67%, respectively. Seventeen (38%) were disease‐free 52 months post‐BMT; 13 were leukemia‐free (eight CR1) at transplant. Eleven relapsed. Three‐year DFS and OS were 42 and 46%, respectively. DFS and OS were longer, and relapses less, for those in CR at time of BMT. Secondary leukemia, cytogenetics, cell dose, and GVHD did not influence outcome. In poor‐risk AML, BAC provided cytoreduction comparable to reported TBI‐containing regimens, when administered for URD BMT. With decreasing treatment‐related mortality, it is justified to proceed early to URD BMT for patients with poor prognostic features. Am. J. Hematol., 2006. © 2006 Wiley‐Liss, Inc.
Type of Medium:
Online Resource
ISSN:
0361-8609
,
1096-8652
Language:
English
Publisher:
Wiley
Publication Date:
2007
detail.hit.zdb_id:
1492749-4
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