Comparable Outcome of Allogeneic versus Autologous Hematopoietic Peripheral Blood Stem Cell Transplantation in Acute Myeloid Leukemia Patients with Normal Karyotype and FLT3-ITD Negative
Yasser H ElNahass*, Hossam K Mahmoud, Alaa M ElHaddad, Omar A Fahmy, Mohamed A Samra, Raafat M Abdelfattah, Hossam A ElAshtoukh, Gamal M Fath and Fatma M ElRefaey
National Cancer Institute, Cairo, Egypt
- *Corresponding Author:
- Yasser H ElNahass
National Cancer Institute
E-mail: [email protected]
Received date: May 23, 2016; Accepted date: August 23, 2016; Published date: August 30, 2016
Citation: ElNahass YH, Mahmoud HK, ElHaddad AM, Fahmy OA, Samra MA, et al. (2016) Comparable Outcome of Allogeneic versus Autologous Hematopoietic Peripheral Blood Stem Cell Transplantation in Acute Myeloid Leukemia Patients with Normal Karyotype and FLT3-ITD. J Leuk 4:214. doi: 10.4172/2329-6917.1000214
Copyright: © 2016 ElNahass YH et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Optimal post-remission treatment for acute myeloid leukemia patients with normal karyotype (AMLNK) in first complete remission (CR1) who lacks an HLA identical donor is still not well-defined.
Aim of the Work: To compare the outcome of allogeneic versus autologous peripheral blood stem cell transplantation (PBSCT) in adult AML patients regarding toxicities of transplant procedure, transplant-related mortality (TRM), disease free survival (DFS) and overall survival (OS).
Patients and Methods: 43 AML patients were included; 34 patients (with a median age 28 years) received myeloablative allogeneic PBSCT from a matched sibling donor while 9 patients (with a median age 36 years) received PBSC autograft. All patients had a normal karyotype (NK), FMS-like tyrosine kinase 3 internal tandem duplication (FLT3 ITD) negative and were in CR1.
Results: After a median follow up of 21.5 months (0.3- 46.5), the cumulative 2-year OS and DFS in the allogeneic group were 73.5% and 70.6% respectively, compared to 74.1% and 64.8%, respectively in the autologous group (p=0.690 and 0.768). Increasing number of consolidation cycles (>3) and lower CD34 stem cell dose were associated with lower relapse rates and higher DFS in the autologous group.
Conclusion: Preliminary data show a comparable outcome of autologous compared to allogeneic PBSCT in patients with AML-NK and FLT3 ITD negative in CR1. In absence of matched sibling donor, autologous PBSCT may provide an acceptable post remission therapy for patients with low risk molecular profile.