Title: Autologous peripheral blood stem cell transplantation for acute myeloid leukemia
Authors: Vellenga, Edo ×
van Putten, Wim
Ossenkoppele, Gert J
Verdonck, Leo F
Theobald, Matthias
Cornelissen, Jan J
Huijgens, Peter C
Maertens, Johan
Gratwohl, Alois
Schaafsma, Ron
Schanz, Urs
Graux, Carlos
Schouten, Harry C
Ferrant, Augustin
Bargetzi, Mario
Fey, Martin F
Lowenberg, Bob #
Issue Date: Dec-2011
Publisher: W.B. Saunders
Series Title: Blood vol:118 issue:23 pages:6037-6042
Abstract: We report the results of a prospective, randomized phase 3 trial evaluating autologous peripheral blood stem cell transplantation (ASCT) versus intensive consolidation chemotherapy in newly diagnosed AML patients in complete remission (CR1). Patients with AML (16-60 years) in CR1 after 2 cycles of intensive chemotherapy and not eligible for allogeneic SCT were randomized between intensive chemotherapy with etoposide and mitoxantrone or ASCT ater high-dose cyclophosphamide and busulfan. Of patients randomized (chemotherapy, n = 259; ASCT, n = 258), more than 90% received their assigned treatment. The 2 groups were comparable with regard to prognostic factors. The ASCT group showed a markedly reduced relapse rate (58% vs 70%, P = .02) and better relapse-free survival at 5 years (38% vs 29%, P = .065, hazard ratio = 0.82; 95% confidence interval, 0.66-1.1) with nonrelapse mortality of 4% versus 1% in the chemotherapy arm (P = .02). Overall survival was similar (44% vs 41% at 5 years, P = .86) because of more opportunities for salvage with second-line chemotherapy and stem cell transplantation in patients relapsing on the chemotherapy arm. This large study shows a relapse advantage for ASCT as postremission therapy but similar survival because more relapsing patients on the chemotherapy arm were salvaged with a late transplantation for relapse. This trial is registered at as # NTR230 and #NTR291. (Blood. 2011;118(23):6037-6042)
ISSN: 0006-4971
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Embryo and Stemcells (-)
× corresponding author
# (joint) last author

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