More efficient mobilisation of peripheral blood stem cells with HiDAC+AMSA+G-CSF than with mini-ICE+G-CSF in patients with AML

Höglund, Martin; Brüne, Martin; Sallerfors, Bengt; Ahlgren, Tomas; Billström, Rolf; Hedenus, Michael; Markevärn, Berit; Nilsson, Bo; Simonsson, Bengt; Stockelberg, Dick; Wåhlin, Anders

doi:10.1038/sj.bmt.1704294

Cited by 3 publications

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References 29 publications

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“…Overall survival (OS) was measured from the date of diagnosis to death from any cause. Relapse‐free survival (RFS) was measured from date of CR until the day of relapse or death from any cause (20).…”

Section: Methodsmentioning

confidence: 99%

“…In case of insufficient stem cell harvest, lack of HLA‐compatible donor, or co‐morbidities, three consolidation courses were given. Harvesting of autologous blood stem cells was performed after mobilizing with granulocyte‐colony‐stimulating factor after chemotherapy, as previously reported (20). Busulfan and cyclophosphamide or total body irradiation and cyclophosphamide were used as preparative regimens for both allo‐ and auto‐SCT.…”

Section: Methodsmentioning

confidence: 99%

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Results of risk‐adapted therapy in acute myeloid leukaemia. A long‐term population‐based follow‐up study

Wåhlin

Billström

Björ

et al. 2009

European J of Haematology

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In 1997-2003, a protocol for treatment of acute myeloid leukaemia (AML) (except promyelocytic leukaemia) was activated in four Swedish health care regions covering 50% of the national population. Based on cytogenetics and clinical findings, patients aged 18-60 yr were assigned to one of three risk groups. In this report we account for the long-term clinical outcome of enrolled patients. Patients received idarubicin and cytarabine in standard doses as induction therapy and consolidation courses included high-dose cytarabine. Allogeneic stem cell transplantation (allo-SCT) from an human leucocyte antigen-identical sibling was recommended in standard and poor-risk patients, whereas unrelated donor transplant was reserved for poor-risk patients. Autologous (auto-SCT) was optional for standard or poor risk patients not eligible for allo-SCT. Two hundred seventy-nine patients with de novo or secondary (9%) AML, median age 51 (18-60) yr, corresponding to 77% of all patients in the population, were included. Twenty (7%) patients were assigned to the good risk group, whereas 150 (54%) and 109 patients (39%) were assigned to standard- and poor-risk groups, respectively. Induction failures accounted for 55 patients; 16 early deaths eight of whom had white blood cell (WBC) >100 at diagnosis, and 39 refractory disease. Thus, complete remission (CR) rate was 80%. At study closure, the median follow-up time of living patients was 90 months. Median survival time from diagnosis in the whole group was 27 months and 4-yr overall survival (OS) rate was 44%. In good, standard, and poor risk groups, 4-yr OS rates were 60, 57 and 24%, respectively. Median relapse-free survival (RFS) time in CR1 was 25 months and RFS at 4 yr was 44%. Four-year RFS rates were significantly (P < 0.001) different between the three risk groups; 64% in good risk, 51% in standard risk and 27% in poor risk patients. One hundred-ten transplantations were performed in CR1; 74 allo-SCT (50 sibling, 24 unrelated donor), and 36 auto-SCT. Non-relapse mortality was 16% for allo-SCT patients. Outcome after relapse was poor with median time to death 163 d and 4-yr survival rate 17%. Three conclusions were: (i) these data reflect treatment results in a minimally selected population-based cohort of adult AML patients <60 yr old; (ii) a risk-adapted therapy aiming at early allogeneic SCT in patients with a high risk of relapse is hampered by induction deaths, refractory disease, and early relapses; and (iii) high WBC count at diagnosis is confirmed as a strong risk factor for early death but not for relapse.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Results of risk‐adapted therapy in acute myeloid leukaemia. A long‐term population‐based follow‐up study

Wåhlin

Billström

Björ

et al. 2009

European J of Haematology

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“…Apparently, Hoglund et al. (11) obtained inferior PBSC mobilisations after Mini‐ICE + G‐CSF in contrast to high dose cytarabine (HiDAC) + amsacrine (AMSA) and G‐CSF in patients with CR‐AML. The authors speculated that idarubicin may have had a negative impact on mobilisation.…”

Section: Discussionmentioning

confidence: 99%

Mini‐ICE effectively mobilises peripheral blood stem cells after fludarabine‐based regimens in acute myeloid leukaemia

Mele

Leopardi

Sparaventi

et al. 2005

European J of Haematology

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Fludarabine-based cycles severely impair mobilisation and collection of peripheral blood stem cells (PBSC) in acute myeloid leukaemia (AML). In an effort of reversing this side-effect, we studied the action on mobilisation and collection of PBSC of a low-dose regimen: 5-d Mini-ICE (oral idarubicin and etoposide; subcutaneous cytosine arabinoside) administered after fludarabine-based regimens in seven adult AML patients. Leukapheresis were started when the CD34+ cell count was more than 10/microL. The median number of harvested CD34+ cells was 8.1 x 10(6)/kg (range 3.08-15.2). All the patients were successfully submitted to PBSC transplantation. Median times to neutrophil and platelet recovery were rapid with a normal transfusional support. We suggest that the Mini-ICE programme is feasible, well tolerated and effective in terms of PBSC mobilisation and collection in low-yield AML patients previously treated with fludarabine. It is well known that a negative effect on stem cell mobilisation and harvest is observed not only after fludarabine administration in AML or low-grade lymphomas, but also after cycles based on different agents, such as thalidomide in multiple myeloma. This preliminary experience, if confirmed on larger series and/or other haematological malignancies, could open new opportunities to perform autologous PBSC transplantation in heavily pretreated cases, allowing a full source of therapeutic options before the start of the mobilisation process.

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Current Awareness in Hematological Oncology

2004

Hematological Oncology

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of hematological oncology. Each bibliography is divided into 14 sections: 1 Books, Reviews & Symposia; 2 General; Leukemias: 3 Lymphoblastic; 4 Myeloid & Myelodysplastic Syndromes; 5 Chronic; 6 Others; Lymphomas: 7 Hodgkin's; 8 Non‐Hodgkin's; 9 Plasmacytomas/Multiple Myelomas; 10 Others; 11 Bone Marrow Transplantation; 12 Cytokines; 13 Diagnosis; 14 Cytogenetics. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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More efficient mobilisation of peripheral blood stem cells with HiDAC+AMSA+G-CSF than with mini-ICE+G-CSF in patients with AML

Cited by 3 publications

References 29 publications

Results of risk‐adapted therapy in acute myeloid leukaemia. A long‐term population‐based follow‐up study

Results of risk‐adapted therapy in acute myeloid leukaemia. A long‐term population‐based follow‐up study

Mini‐ICE effectively mobilises peripheral blood stem cells after fludarabine‐based regimens in acute myeloid leukaemia

Current Awareness in Hematological Oncology

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