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Autografting

BU/melphalan and auto-SCT in AML patients in first CR: a ‘Gruppo Italiano Trapianto di Midollo Osseo (GITMO)’ retrospective study

Bone Marrow Transplantation volume 45, pages 640–646 (2010)Cite this article

Abstract

AML patients (total 129; median age =50 years; range 16–72) in first CR received BU and melphalan (BU/Mel) as conditioning regimen before auto-SCT. In all, 82 patients (63.6%) received PBSCs and 47 patients (36.4%) received BM cells. The distribution of cytogenetic categories was conventionally defined as favorable (15.5%), intermediate (60.1%) and unfavorable (24.3%). With a median follow-up of 31 months, the 8-year projected OS and disease-free survival (DFS) was 62 and 56% for the whole population, respectively. The relapse rate was 46% and the non-relapse mortality was 4.65%. Although PBSC transplantation led to a faster hematological recovery than BM transplantation, in univariate analysis the stem cell source, cytogenetics and different BU formulations did not significantly affect OS and DFS, whereas age and the number of post-remission chemotherapy cycles did have a significant effect on the clinical outcome. Multivariate analysis identified age <55 years as the only important independent predictor for OS and DFS. Our data suggest that BU/Mel, being associated with a low toxicity profile (mainly mucositis) and mortality, is an effective conditioning regimen even for high-risk AML patients in first CR undergoing auto-SCT.

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Acknowledgements

This work was supported by the Italian Ministry of Health (Progetto Strategico Oncologia, 2006), Regione Emilia-Romagna (Progetti di Ricerca Università-Regione Emilia Romagna, Progetto Medicina Rigenerativa, 2007) and the Italian Association Against Leukemia, Bologna (BolognAil).

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Authors and Affiliations

  1. Institute of Hematology ‘L & A Seràgnoli’, University of Bologna and Stem Cell Research Center, SOrsola-Malpighi Hospital, Bologna, Italy

    R M Lemoli, A D'Addio & A De Vivo

  2. Department of Hematology, Stem Cell Transplantation Unit, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    G Marotta

  3. Hematology Unit, Ospedale Cardarelli di Napoli, Italy

    L Pezzullo

  4. Division of Haematology, SMaria delle Croci Hospital, Ravenna, Italy

    E Zuffa

  5. Department of Hematology, Medical School, University of Ancona, Ancona, Italy

    M Montanari

  6. Hematology Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy

    A Bonini

  7. UOS di Ematologia—Ospedale Mazzoni, Ascoli Piceno, Italy

    P Galieni

  8. Ematologia e Centro Trapianti CSE, IRCCS Ospedale ‘Casa Sollievo della Sofferenza’, San Giovanni Rotondo (FG), Italy

    A M Carella

  9. Department of Haematology, Stem Cell Transplantation Unit, Careggi Hospital, University of Florence, Florence, Italy

    S Guidi & A Bosi

  10. Department of Medical Oncology, Cell Therapy and Stem Cell Transplantation Unit, Aviano, Pordenone, Italy

    M Michieli

  11. Department of Hematology, Azienda Ospedaliera San Carlo, Potenza, Italy

    A Olivieri

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Lemoli, R., D'Addio, A., Marotta, G. et al. BU/melphalan and auto-SCT in AML patients in first CR: a ‘Gruppo Italiano Trapianto di Midollo Osseo (GITMO)’ retrospective study. Bone Marrow Transplant 45, 640–646 (2010). https://doi.org/10.1038/bmt.2009.235

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