Akut myelositer lösemi hastalarında konsolidasyon tedavisi olarak otolog hematopoetik kök hücre nakli uygulaması

Abstract

Aim: Autologous stem cell transplantation (ASCT) is a treatment option as a consolidation therapy in acute myeloid leukemia (AML) patients. ASCT may improve disease free survival without effecting overall survival rates when compared with high dose Ara-C (HDARAC). ASCT becomes even more important after mortality and morbidity rates decrease with the new improvements. In this study, we analyzed the results of patients treated with ASCT after HDARAC therapy in the first remission. Materials and Methods:AML patients diagnosed between 1998 and 2012 were retrospectively analyzed. After remission achieved by induction therapy and HDARAC consolidation therapy (3 gr/m 2 , on alternate 3 days) 23 patients who were treated with ASCT were enrolled in the study. Statistical analysis and survival rates were analyzed by Graphpad 4.03 and the results were reported as median (range, minimum-maximum). Results:The median time to neutrophil and thrombocyte engraftments was 12 (range, 8-28) days and 14 (8-100) days, respectively. We did not document any transplantation related mortality. Fifteen patients relapsed after ASCT and 13 of them died due to refractory disease. The median follow up period was 40 (range, 6-144) months. The median overall survival and disease free survival were 48 and 34 months, respectively. The overall survival rate was 32.2% at 144 th month and the disease free survival rate was 27.3 % at 130th month. Conclusion:ASCT may provide a long term disease free survival in AML patients after one cycle of induction chemotherapy and HDARAC as a consolidation therapy. Especially in AML patients without suitable related or unrelated donors, ASCT may provide a treatment option.Keywords: Acute myeloid leukemia, autologous peripheral stem cell transplantation, consolidation, survival.