Autologous or Allogeneic Bone Marrow Transplantation Compared with Consolidation Chemotherapy in Acute promyelocytic Leukemia.
- Author:
Chang Ki MIN
1
;
Woo Sung MIN
;
Hee Je KIM
;
Hyun Suk EOM
;
Jong Wook LEE
;
Kyungja HAN
;
Ihl Bhong CHOI
;
Chun Choo KIM
;
Won IL KIM
;
Dong Jip KIM
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Acute promyelocytic leukemia;
Consolidation chemotherapy;
Bone marrow transplantation
- MeSH:
Bone Marrow Transplantation*;
Bone Marrow*;
Cause of Death;
Consolidation Chemotherapy*;
Cytarabine;
Disseminated Intravascular Coagulation;
Drug Therapy;
Fibrinolysis;
Follow-Up Studies;
Humans;
Leukemia, Myeloid, Acute;
Leukemia, Promyelocytic, Acute*;
Mortality;
Recurrence;
Stem Cell Transplantation
- From:Journal of the Korean Cancer Association
1999;31(2):331-338
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Acute promyelocytic leukemia (APL) is a distinct subtype of acute myelogenous leukemia characterized by the morphology of blast cells (M3 in FAB classification), the t (15;17) translocation, and a coagulopathy combining disseminated intravascular coagulation and fibrinolysis. It has been considered to have better response to combination chemo- therapy of an anthracycline and cytosine arabinoside and a higher cure rate than other subtypes because of recent approach of differentiating leukemic blasts by all-transretinoic acid (ATRA). The role of stem cell transplantation in APL has to be determined in comparison with that of consolidation chemotherapy. MATERIALS AND METHODS: We compared the leukemia-free survival and overall survival between APL patients receiving the consolidation chemotherapy and those undergoing the allogeneic or autologous stem cell transplantation following the high-dose anticancer therapy. Of the 65 patients achieving the first complete remission from 1992 to 1997, 33 patients were treated with 3 courses of consolidation chemotherapies and 32 with the stem cell transplantation. RESULTS: With a median follow-up of 22 months (8-60), the actuarial leukemia-free survival at 3 years was significantly higher in transplantation group than in chematherapy group (73.8% versus 33.5%; P=0.0087), and the probability of leukemic relapse was considerably lower in transplantation group than in chemotherapy group (6.3% versus 57.5%; P=0.001). The treatment-related mortalities of the groups were 0% in chemotherapy group and 14.3% in transplantation group. The main cause of deaths was relapse in the consolidation chemotherapy group. CONCLUSION: These data demonstrate that the stem cell transplantation results in better leukemia-free survival than the consolidation chemotherapy for patients with APL in the first complete remission because of lower risk of relapse.
