Etoposide plus cytarabine versus cyclophosphamide or melphalan in busulfan-based preparative regimens for autologous stem cell transplantation in adults with acute myeloid leukemia in first complete remission: a study from the Acute Leukemia Working Party of the EBMT

被引：0

作者：

Jaime Sanz

Myriam Labopin

Thomas Pabst

Jurjen Versluis

Gwendolyn Van Gorkom

Ellen Meijer

Tobias Gedde-Dahl

Juan Montoro

William Arcese

Jose Antonio Pérez-Simón

Nicolaas Schaap

Johan Maertens

Radovan Vrhovac

Francesco Lanza

Norbert Claude Gorin

Mohamad Mohty

Fabio Ciceri

机构：

[1] Hospital Universitari i Politècnic La Fe,Hematology Department

[2] CIBERONC,EBMT Paris Office

[3] Instituto Carlos III,Department of Medical Oncology

[4] Hospital Saint Antoine,Erasmus MC Cancer Institute, Department of Hematology

[5] University Hospital,Department Internal Med.Hematology/Oncology

[6] Inselspital,Department of Hematology (Br 250)

[7] University Medical Center Rotterdam,Clinic for Cancer Medicine, Hematology Department, Section for Stem Cell Transplantation

[8] University Hospital Maastricht,Department of Hematology

[9] VU University Medical Center,Hematology Unit

[10] Oslo University Hospital,Hôpital Saint

[11] Rikshospitalet,Antoine

[12] Tor Vergata University of Rome,undefined

[13] Stem Cell Transplant Unit,undefined

[14] Policlinico Universitario Tor Vergata,undefined

[15] Servicio de Hematologia y Hemoterapia,undefined

[16] Hospital Universitario Virgen del Rocío,undefined

[17] Instituto de Biomedicina de Sevilla (IBIS/CISC),undefined

[18] Radboud University Medical Centre,undefined

[19] University Hospital Gasthuisberg,undefined

[20] University Hospital Center Rebro,undefined

[21] Ravenna Hospital- University of Bologna,undefined

[22] Sorbonne University,undefined

[23] INSERM UMRs 938,undefined

[24] Ospedale San Raffaele s.r.l.,undefined

[25] Haematology and BMT,undefined

来源：

Bone Marrow Transplantation | 2023年 / 58卷

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摘要：

We retrospectively compared the impact of the conditioning regimen in adult patients with acute myeloid leukemia (AML) in first complete remission (CR1) that received high-dose myeloablative chemotherapy followed by autologous stem cell transplantation (ASCT) from 2010 to 2021 with either high-dose cytarabine, etoposide and busulfan (BEA), busulfan with cyclophosphamide (BUCY) or busulfan and high-dose melphalan (BUMEL) registered in the EBMT database. Overall 1560 patients underwent ASCT, of which 156, 1143 and 261 received BEA, BUCY and BUMEL, respectively. Compared to BUCY and BUMEL, BEA patients were younger (p < 0.001) and less frequently had NPM1 mutations (p = 0.03). Transplant outcomes at 5 years with BEA, BUCY and BUMEL were: cumulative incidence of relapse 41.8%, 46.6% and 51.6%; non-relapse mortality (NRM) 1.5%, 5.2% and 7.3%; probability of leukemia-free survival (LFS) 56.7%, 48.2% and 41.1%; and overall survival (OS) 71.3%, 62.3% and 56%, respectively. In multivariable analysis the BEA regimen showed significant improvement in OS compared to BUCY (hazard ratio [HR] 0.65; 95% CI, 0.42–0.83; p = 0.048) and BUMEL (HR 0.59; 95% CI, 0.37–0.94; p = 0.029). In conclusion, high-dose myeloablative combination chemotherapy with BEA offered improved outcomes compared to classical BUCY or BUMEL in patients with AML in CR1 undergoing ASCT.

引用

页码：1197 / 1202

页数：5

共 127 条

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