High-dose treatment with autologous bone marrow support as consolidation of first remission in younger patients with acute myelogenous leukaemia

Rohatiner, A. Z. S.; Bassan, Renato; Raimondi, Roberto; Amess, J. A. L.; Arnott, S.J.; Personen, A.; Rodeghiero, Francesco; Barbui, Tiziano; Bradburn, Michael; Carter, M.; Lister, T. Andrew

doi:10.1023/a:1008333903220

Cited by 14 publications

(9 citation statements)

References 31 publications

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“…The introduction of new and intensive chemotherapeutic regimens followed by bone marrow or peripheral stem cell transplantation, along with improved monitoring and supportive measures, have led to these improvements in outcomes. [8][9] Unfortunately, use of these aggressive chemotherapeutic regimens frequently leads to life threatening complications requiring ICU monitoring and support. The positive impact on overall survival associated with these treatments can lead haematologists to fail to appreciate the poor prognosis associated with ICU admission.…”

Section: Introductionmentioning

confidence: 99%

The Outcome of Haematological Malignancy in Scottish Intensive Care Units

Cuthbertson

Rajalingam

Harrison

et al. 2008

Journal of the Intensive Care Society

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On behalf of the Scottish Intensive Care SocietyTo study the prognostic indicators and outcome in patients with haematological malignancy requiring intensive care, we identified 714 adult patients and analysed their clinical audit data. Mean APACHE II score was 24. Main admitting diagnoses were acute lymphoma (43%) and acute leukaemia (28%). There was a high requirement for acute organ support. Intensive care unit (ICU) mortality was 39% and hospital mortality 55%, with a standardised mortality rate of 1.05 (0.98-1.13). Factors predictive of outcome after multivariate analysis were: cardiopulmonary resuscitation (CPR) in the 24-hours before ICU admission, inotropic support in the first 24-hours, APACHE II score and requirement for ventilatory support immediately prior to, or at admission to the ICU. Neutropaenia was not an independent predictor. Patients with neutropaenic septic shock and multiorgan failure left hospital. Hospital mortality for this group is comparable to that of non-cancer patients admitted with multi-organ system failure. The reluctance to admit such patients to ICU may be unjustified.

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Section: Introductionmentioning

confidence: 99%

The Outcome of Haematological Malignancy in Scottish Intensive Care Units

Cuthbertson

Rajalingam

Harrison

et al. 2008

Journal of the Intensive Care Society

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“…The choice of treatment was based on the patient's age. All but three patients 560 years of age received idarubicin, AraC and etoposide (ICE) induction therapy (Table III) [23]. In all protocols two to three consolidation courses were given.…”

Section: Treatmentmentioning

confidence: 99%

“…Allogeneic stem cell transplantation (allo-SCT) was performed in 13 patients in first CR (5 with sibling donors and 8 with unrelated donors) [24]. Fourteen patients were submitted to autologous SCT (auto-SCT) in first CR [23]. All patients who underwent SCT were younger than 60 years.…”

Section: Treatmentmentioning

confidence: 99%

Expression patterns of CD33 and CD15 predict outcome in patients with acute myeloid leukemia

Derolf¹,

Björklund

Mazur

et al. 2008

Leukemia & Lymphoma

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Expression patterns of CD33 and CD15 in normal/reactive bone marrow (n = 13) and in leukemic blasts from patients with acute myeloid leukemia (n = 129) were determined using multiparameter flow cytometry and a standard panel of triple antibody combinations. Five patterns, corresponding to the consecutive stages of myeloid differentiation, were identified [I: CD33-/CD15- (n = 18), II: CD33+/CD15- (n = 43), III: CD33+/CD15 heterogeneous (n = 10), IV: CD33+/CD15+ (n = 50), V: CD33-/CD15+ (n = 8)]. Patients with pattern II had the highest relapse rate and shortest median overall survival (OS, 8 months), but they were also the oldest (median age 72 years) and had the highest frequency of unfavorable cytogenetic aberrations. Pattern V patients had a short OS (median 14 months) even though they were the youngest (median age 50 years), had high remission rate and did not have unfavorable cytogenetics. In multivariate analysis, age, cytogenetics, CD15 expression and the presented immunophenotypic classification were significant for OS (age p = 0.004, cytogenetics p = 0.011, immunophenotype pattern p = 0.024, CD15 p = 0.031). Age (p = 0.001) and immunophenotypic classifications (p = 0.015) were significant for disease-free survival in patients who achieved complete remission.

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“…Autologous blood and marrow transplantation (ABMT) is a curative procedure for adults with acute myeloid leukemia (AML) [11,14] as well as those with relapsed nonHodgkin's lymphoma (NHL) [11,13,17] and Hodgkin's disease (HD) [11] It also improves survival in patients with myeloma [2]. With expanding indications, the use of ABMT has been steadily increasing over the last 25 years [8].…”

Section: Introductionmentioning

confidence: 99%

The autologous blood and marrow transplant long-term follow-up clinic: a model of care for following and treating survivors of autotransplant

Schimmer

Dranitsaris

Ali

et al. 2002

Support Care Cancer

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The number of long-term survivors of autologous blood and marrow transplantation (ABMT) is increasing, but little is known about the models of care used to follow these patients. Such information would help in comparison of different methods of follow-up and allow other centers to create programs to follow their survivors. Here we describe a multidisciplinary long-term follow-up clinic for survivors of ABMT and report patient satisfaction with the clinic and economic analysis 1.5 years after its inception. In its first 1.5 years of operation, 83 new patients were seen in the clinic. Patients were evaluated a median of 4.0 years after ABMT (range 4.9 months to 12 years) and were a median of 48.5 years (range 22.5-69.0 years) old. Patients received their ABMT for non-Hodgkin's lymphoma ( n=26), Hodgkin's disease ( n=18), acute myeloid leukemia ( n=18), multiple myeloma ( n=15), breast cancer ( n=5), or desmoplastic round-cell tumor ( n=1). Patient satisfaction was assessed 1.5 years after the establishment of the long-term follow-up clinic by means of a self-report questionnaire. Seventy-five percent of patients returned the survey. Waiting times in the clinic were short, with 70% of patients seen within 30 minutes of arrival. Overall, patients were very satisfied with the new clinic model, with 85% patients reporting that the clinic met their expectations. An economic analysis indicated that the estimated annual cost of operating the clinic was approximately $53,000, which translates into $440 per patient visit, $962 per new patient or $172 per patient visit with the clinic operating at peak capacity. In conclusion, we present an inexpensive model of care for ABMT survivors that can be extended to adult survivors of malignancy not treated by ABMT.

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High-dose treatment with autologous bone marrow support as consolidation of first remission in younger patients with acute myelogenous leukaemia

Cited by 14 publications

References 31 publications

The Outcome of Haematological Malignancy in Scottish Intensive Care Units

The Outcome of Haematological Malignancy in Scottish Intensive Care Units

Expression patterns of CD33 and CD15 predict outcome in patients with acute myeloid leukemia

The autologous blood and marrow transplant long-term follow-up clinic: a model of care for following and treating survivors of autotransplant

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