Autologous Stem Cell Transplantation in Patients with Acute Myeloid Leukemia: a Single-Centre Experience

Abstract

Introduction: Autologous haemopoietic stem cell transplantation (SCT) is an important treatment modality for patients with acute myeloid leukemia with low and intermediate risk disease. It has served advantages over allogenic transplantation, because it does not need a matched donor, there is no graft versus host disease, there are less complications and a faster immune reconstitution than in the allo-setting. The disadvantage is the lack of the graft versus leukaemia effect. Materials and methods: In the Bone Marrow Transplantation Unit Tîrgu Mureș 14 patients with acute myeloid leukemia received an autologous SCT. Mobilization of the stem cells was performed using chemotherapy and granulocytic colony stimulating factor. The conditioning regimen for SCT consists in monotherapy with busulfan (Bu) 16 mg/kg, BuCy: busulfan in combination with Cyclophosphamide (CY) 120 mg/ kg or BuMel: Busulfan in association with Melphalan (Mel) 140 mg/m2. Results: The median patient age was 36 years (range 20-55), 9 (64%) were males and 5 (36) were females and the median time interval from diagnosis to autologous SCT was 9 months (range 3-25). All the patients were transplanted successfully, all of them achieved a sustained neutrophil count (> 0.5 G/L), median time 11 days (9-15) and platelet count (> 20 G/L) median time 14 days (10-19) after transplantation. Conclusions: We conclude that autologous stem cell transplantation is an effective treatment in acute myeloid leukemia with the possibility of long survival, particularly in patients with standard risk disease

Update on Non-M3 Acute Myeloid Leukemia — Etiology, Classification, Risk Stratification, Emergencies, Complications, Disease in Special Circumstances and Current and Future Therapeutics

“…Autologous HSCT is an effective therapeutic modality in AML with the possibility of longterm survival, particularly in patients with standard-risk AML [168,169]. Several historical randomized trials have reported significantly lower relapse rates after autologous HSCT than after conventional chemotherapy [170,171].…”

“…(1) faster hematological engraftment reflected by the recovery of blood indices, (2) the possibility of applying this form of transplant in older patients, (3) lower incidences of transplant-related complications, (4) faster immune reconstitution, and (5) absence of GVHD [169]. However, autologous HSCT has few disadvantages including: lack of GVL effect, insufficient number of peripheral stem cells at mobilization, and higher incidence of relapse [169].…”

“…(1) faster hematological engraftment reflected by the recovery of blood indices, (2) the possibility of applying this form of transplant in older patients, (3) lower incidences of transplant-related complications, (4) faster immune reconstitution, and (5) absence of GVHD [169]. However, autologous HSCT has few disadvantages including: lack of GVL effect, insufficient number of peripheral stem cells at mobilization, and higher incidence of relapse [169]. Faster recovery of blood counts following autologous HSCT has the following advantages: shorter duration of hospitalization, decreased need for blood product transfusion, and reduction in the days of IV antimicrobials [172].…”