Randomised comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukaemia in first remission: results of MRC AML 10 trial

Burnett, Alan Kenneth; Goldstone, Anthony H.; Stevens, Robert G.; Hann, Ian; Rees, J. K. H.; Gray, Richard; Wheatley, Keith

doi:10.1016/s0140-6736(97)09214-3

Cited by 519 publications

(384 citation statements)

References 16 publications

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“…The role of ASCT in AML remains controversial. Phase II and III trials showed that ASCT provides lower relapse rates than conventional CHT and improves DFS in some but not in all studies [3,[7][8][9]. Our retrospective study analyzed the role of ASCT in patients with AML, with good, intermediate and poor prognostic features.…”

Section: Discussionmentioning

confidence: 99%

“…In table 3 we compared our results with three large phase III randomized studies [7][8][9], ALWP-EBMT registry [10] and two recent long-term single institution studies [1,4]. It is now well proven that hemopoiesis recovery (engraftment) is more rapid with PBSCT than with BMSCT [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…However, the results in patients with high cytogenetic risk disease were dismal and not superior to published results of CHT alone after attaining CR. [1,2,8,[14][15][16]. Therefore, patients with poor cytogenetic prognosis AML lacking an HLA-matched donor should probably be offered an allogeneic SCT from an alternative unrelated donor or from a haplotype-mismatched related donor.…”

Section: Discussionmentioning

confidence: 99%

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Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

Demečková²,

Bojtárová³

et al. 2012

neo

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Background: the role of autologous stem cell transplantation (ASCT) in treatment of acute myeloid leukemia (AML) remains unsettled. Aims: retrospective analysis to evaluate the role of ASCT in patients with AML without HLA-matched donor. Methods: between December 19, 1994 and August 1, 2012, a total of 63 patients with AML without HLA-matched donor in the department of Hematology and Transfusion Medicine, University Hospital, Bratislava, received an ASCT. Median age was 41 years (20-61 years). There were 35 (56%) males and 28 (44%) females. At the time of ASCT, 50 (79%) patients were in first complete remission (CR), 11 (18%) patients were in second CR and 2 (3%) patients were in relapse. Results: with a median follow-up of 115 months (34-214 months), the 10 year overall survival (OS) and disease free survival (DFS) of all patients was 55% and 51%, respectively. Transplant-related mortality was 6%. The relapse rate was 38% and 9 years probability of relapse was 44%. Conclusion: ASCT is still an effective post-remission treatment in AML patients without HLA-matched donor; with the possibility of long-term survival or even cure in remarkable proportion of patients with AML, particularly in patients with favorable and intermediate cytogenetic risk.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

Demečková²,

Bojtárová³

et al. 2012

neo

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“…Three treatment modalities are generally applied: intensive consolidation chemotherapy, hematopoietic SCT or maintenance chemotherapy. 1,2 Auto-SCT (ASCT) resulted in a better outcome in terms of disease-free survival (DFS) and relapse rate when compared with intensive consolidation chemotherapy, but usually OS was not significantly different, partly due to a better response to second line therapy after relapse. [1][2][3] Nevertheless, several study groups consider ASCT as the treatment of choice for intermediate and high-risk AML patients if allo-SCT is not applicable.…”

Section: Introductionmentioning

confidence: 99%

High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT

Hengeveld

Suciu

Chelgoum³

et al. 2014

Bone Marrow Transplant

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The faster hematopoietic recovery after autologous peripheral blood SCT (APBSCT) in patients with AML may be offset by an increased relapse risk as compared with autologous BMT (ABMT). The EORTC and GIMEMA Leukemia Groups conducted a trial (AML-10) in which they compared, as second randomization, APBSCT and ABMT in first CR patients without an HLA compatible donor. A total of 292 patients were randomized. The 5-year DFS rate was 41% in the APBSCT arm and 46% in the ABMT arm with a hazard ratio (HR) of 1.17; 95% confidence interval = 0.85-1.59; P = 0.34. The 5-year cumulative relapse incidence was 56% vs 49% (P = 0.26), and the 5-year OS 50% and 55% (P = 0.6) in the APBSCT and ABMT groups, respectively. APBSCT was associated with significantly faster recovery of neutrophils and platelets, shorter duration of hospitalization, reduced need of transfusion packed RBC and less days of intravenous antibiotics. In both treatment groups, higher numbers of mobilized CD34+ cells were associated with a significantly higher relapse risk irrespective of the treatment given after the mobilization. Randomization between APBSCT and ABMT did not result in significantly different outcomes in terms of DFS, OS and relapse incidence.

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“…A NMR was negative for neurohypophysis infiltration. The patient thereafter started induction chemotherapy according to Burnett et al (1998). On d 26, a BM analysis showed resistance to therapy with 80% blast cells; the platelet count was 253 · 10 9 /l.…”

Section: Casementioning

confidence: 99%

Diabetes insipidus as first manifestation of acute myeloid leukaemia with EVI‐1‐positive, 3q21q26 syndrome and T cell‐line antigen expression: what is the EVI‐1 gene role?

Breccia

Petti

Ottaviani³

et al. 2002

Br J Haematol

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Summary. Two cases of acute myeloid leukaemia (AML) with CD2 and CD7 expression associated with diabetes insipidus (DI) as the initial symptom are presented. Both patients had t(3;3)(q21;q26) associated with monosomy 7 and EVI-1 overexpression. No neurohypophysis infiltration was evident. One patient died during induction chemotherapy, the other did not respond to therapy and died with persistent DI. Our findings further support the existence of a distinct AML entity characterized by the presence of DI, abnormalities of chromosome 3q, dysmegakaryopoiesis and poor outcome, and provide evidence of EVI-1 gene involvement. The possible role of chromosome 3q26 abnormalities in determining this peculiar clinical-biological association is emphasized.

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Randomised comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukaemia in first remission: results of MRC AML 10 trial

Cited by 519 publications

References 16 publications

Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT

Diabetes insipidus as first manifestation of acute myeloid leukaemia with EVI‐1‐positive, 3q21q26 syndrome and T cell‐line antigen expression: what is the EVI‐1 gene role?

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Randomised comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukaemia in first remission: results of MRC AML 10 trial

Cited by 519 publications

References 16 publications

Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

High numbers of mobilized CD34+ cells collected in AML in first remission are associated with high relapse risk irrespective of treatment with autologous peripheral blood SCT or autologous BMT

Diabetes insipidus as first manifestation of acute myeloid leukaemia with EVI‐1‐positive, 3q21q26 syndrome and T cell‐line antigen expression: what is the EVI‐1 gene role?

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Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?

Is there still a role for autologous stem cell transplantation in acute myeloid leukemia?