No impact of high-dose cytarabine on the outcome of patients transplanted for acute myeloblastic leukaemia in first remission

Jean Yves Cahn, Myriam Labopin, Jorge Sierra, Didier Blaise, Josy Reiffers, Augustin Ferrant, Lothar Bergmann, Giuseppe Visani, Jan Cornelissen, Theo De Witte, Alberto Bosi, Francesco Frassoni, Norbert Claude Gorin

Research output: Contribution to journalArticlepeer-review

Abstract

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 stem 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. In 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.

Original languageEnglish
Pages (from-to)308-314
Number of pages7
JournalBritish Journal of Haematology
Volume110
Issue number2
DOIs
Publication statusPublished - 2000

Keywords

  • Acute myeloblastic leukaemia
  • Bone marrow transplantation
  • Cytarabine

ASJC Scopus subject areas

  • Hematology

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