Since 1984 we have autografted a total of 60 patients with AML in second complete remission (CR) utilizing the BAVC (BCNU, amsacrine, vepesid, cytosine-arabinoside) conditioning regimen and unpurged marrow. Projected disease-free survival (DFS) probability is 42% at 10 years. Autografting was performed at a median interval of 2 months (range 1-13) from second CR, The median duration of first CR was 14 months (range 1-43) and lasted less than or equal to 12 months in 27/60 patients, Three early deaths (5%) occurred, 30 patients relapsed after a median of 6 months from transplant (range 2-28) and, of the remaining 27 patients, 26 are in continuous CR (CCR) after a median follow up of 60 months (range 6-122), while the last patient committed suicide 7 years after ABMT when she was still in CCR. A first CR duration >12 months is correlated with a significantly better overall survival probability (61 vs 25%, P = 0.02), while no factors influence DFS. Outcome of patients who relapsed after autografting has been analyzed separately; a longer overall survival after relapse is correlated with a longer duration of the second CR (62% at 34 months for patients who relapsed after >12 months from the autograft vs 5% for the others, P=0.001). These results confirm that AML patients autografted in second CR with BAVC regimen and unpurged marrow have the possibility of becoming long-term DFS and can therefore be cured.
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|Titolo:||BAVC regimen and autograft for acute myelogenous leukemia in second complete remission|
|Data di pubblicazione:||1996|
|Appartiene alla tipologia:||01a Articolo in rivista|