No impact of high-dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission
No impact of high-dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission
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DOI：
10.1046/j.1365-2141.2000.02178.x
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发表时间：
2000-08-01
影响因子：
6.5
通讯作者：
Gorin, NC
中科院分区：
文献类型：
--
作者：
Cahn, JY;Labopin, M;Gorin, NC
高剂量阿糖胞苷目前与蒽环类药物联合用于治疗急性成髓细胞白血病（AML）。此外，据报道，高剂量阿糖胞苷在一定比例的患者中产生长期无病生存，特别是在某些AML亚型中。然而，目前尚不清楚接受同种异体或自体干细胞移植的患者的结局是否受到既往高剂量阿糖胞苷治疗的影响。为此，根据诱导和/或巩固时给予的阿糖胞苷剂量强度，分析了1672例首次缓解的AML患者，这些患者报告给欧洲血液和骨髓移植组（EBMT）急性白血病工作组登记处，并在1980年至1995年期间接受移植。其中自体干细胞移植（ABMT）846例，异基因骨髓移植（BMT）826例。这项研究表明，阿糖胞苷（Ara-C）的剂量在诱导和/或巩固没有影响患者随后同种异体移植或自体移植的复发率。此外，就总体结局而言，它没有带来任何优势。因此，计划进行干细胞移植（SCT）作为缓解后治疗的患者可能不需要高剂量（HD）Ara-C。然而，HD Ara-C可用于某些被认为可通过单独化疗治愈的AML亚型。
High-dose cytarabine is currently used in combination with anthracycline in the treatment of acute myeloblastic leukaemia (AML). Moreover, high-dose cytarabine has been reported to produce long-term disease-free survival in a proportion of patients, especially in certain subtypes of AML. However, it remains unknown whether the outcome of patients undergoing allogeneic or autologous stern cell transplantation is influenced by previous treatment with high-dose cytarabine. To this end, 1672 patients with AML in first remission who were reported to the Acute Leukaemia Working Party registry of the European Group for Blood and Marrow Transplantation (EBMT) and who were transplanted between 1980 and 1995 were analysed according to the dose intensity of cytarabine given at induction and/or consolidation. Autologous stem cell transplantation (ABMT) was performed in 846 patients and allogeneic bone marrow transplantation (BMT) in 826 patients. This study shows that the dose of cytarabine (Ara-C) given at induction and/or consolidation did not influence the relapse incidence in patients subsequently allografted or autografted. Tn addition, it did not give any advantage in terms of overall outcome. Therefore, high-dose (HD) Ara-C may not be needed for patients who have a planned stem cell transplantation (SCT) as post-remission therapy. Nevertheless, HD Ara-C may be utilized in certain subtypes of AML that are believed to be curable by chemotherapy alone.