Effect of postremission high dose cytarabine-based consolidation chemotherapy before allogenic stem cell transplantation in outcomes of acute myeloid leukemia patients

Transfus Apher Sci. 2018 Dec;57(6):752-755. doi: 10.1016/j.transci.2018.09.013. Epub 2018 Sep 18.

Abstract

Background and aim: This is a retrospective study aiming to investigate the effect of the number of high dose cytarabine-based chemotherapy (HiDAC) courses in patients with acute myeloid leukemia before allogenic stem cell transplantation (ASCT).

Materials and methods: A total of 110 patients with acute myeloid leukemia who received ASCT between 2001 and 2018 were included in the study.

Results: Of the 110 patients, 25 (23%) patients received one course of HiDAC, 42 (38%) patients received two courses of HiDAC, 34 (31%) patients received three courses of HiDAC and 9 (8%) patients received four courses of HiDAC. Median follow-up for survivors was 71 months (range 4-186) for all patients. The 3-year overall survival for patients who received one course of HiDAC and patients who received more than one course of HiDAC were 49% and 70%, respectively (p = 0.29). The 3-year disease free survival (DFS) for patients who received one course of HiDAC and patients who received more than one course of HiDAC were 38% and 66%, respectively (p = 0.05). There was no statistically significant difference in OS between patients who received one or more than one consolidation chemotherapy. But there was nearly a statistically significant difference between patients who received one or more than one consolidation chemotherapy in DFS.

Conclusion: In conclusion, the administration of more than one consolidation chemotherapy may provide longer DFS, however the number of consolidation chemotherapy is not associated with statistically significant differences in overall outcomes.

Keywords: Acute myeloid leukemia; Allogeneic stem cell transplantation; High-Dose cytarabine.

MeSH terms

  • Adult
  • Aged
  • Consolidation Chemotherapy*
  • Cytarabine / pharmacology
  • Cytarabine / therapeutic use*
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / pathology
  • Male
  • Middle Aged
  • Remission Induction
  • Stem Cell Transplantation*
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Cytarabine