Hong Kong Med J 2000;6:37–42 | Number 1, March 2000
Autologous bone marrow transplantation for patients with acute myeloid leukaemia: prospective follow-up study
YK Mak, CH Chan, YC Chu, YT Chen, CK Lau, JSM Lau
Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong
OBJECTIVE. To study the use of autologous bone marrow transplantation to treat acute myeloid leukaemia when complete remission had been achieved and when no human leukocyte antigen-matched related donor was available.
DESIGN. Prospective follow-up study.
SETTING. Government hospital, Hong Kong.
PATIENTS. Eight patients (median age, 34 years [range, 16-45 years]) with acute myeloid leukaemia in whom complete remission had been achieved.
INTERVENTION. Conditioning regimen of carmustine, amsacrine, etoposide VP-16, cytarabine, and infusion of unpurged marrow.
MAIN OUTCOME MEASURES. Median time taken to reach neutrophil and platelet counts of >/=0.5 x 10^9 /L and >/=20 x 10^9 /L, respectively; mortality and relapse rates; and follow-up regimens used.
RESULTS. Engraftment was successfully achieved in all patients and there were no early procedure-related mortalities. The median times required to reach a neutrophil count of >/=0.5 x 10^9 /L and a platelet count of >/=20 x 10^9 /L were 30 days (range, 18-36 days) and 38 days (range, 15-53 days), respectively. The median duration of hospital stay was 37 days (range, 25-43 days). Two patients died of a relapse of leukaemia at 6 and 9 months post-transplantation. Two patients experienced relapses: one at 8 months post-transplantation, for which conventional chemotherapy was restarted, and one at 18 months; treatment with all-trans-retinoic acid and conventional chemotherapy achieved a third complete remission in the latter patient, who had acute promyelocytic leukaemia. Continuous remission has been achieved in four of the eight patients after a median follow-up duration of 26 months (range, 6-43 months).
CONCLUSION. Autologous bone marrow transplantation is an acceptable treatment for patients with acute myeloid leukaemia who lack a human leukocyte antigen-matched related donor.
Key words: Antineoplastic agents, combined; Bone marrow transplantation; Combined modality therapy; Leukemia, myelocytic, acute; Survival analysis
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