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J Korean Soc Ther Radiol Oncol > Volume 21(3); 2003 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2003;21(3): 192-198.
Effect of Cytarabine, Melphalan, and Total Body Irradiation as Conditioning for Autologous Stem Cell Transplantation for Patients with AML in First Remission
Ki Mun Kang, Byung Ock Choi, Gyu Young Chai, Young Nam Kang, Hong Sek Jang, Hee Jae Kim, Wo Sung Min, Chun Choo Kim, Ihl Bohng Choi
1Department of Therapeutic Radiology, Gyeongsang National University, Korea. jsk92@nongae.gsnu.ac.kr
2Gyeongsang Institute of Health Sciences, Jinju, Korea.
3Department of Radiation Oncology, Korea.
4The Catholic University of Korea, Korea.
5The Catholic Hematopoietic Stem Cell Transplantation Center, Seoul, Korea.
Current results of autologous stem cell transplantation (SCT) suggest that this procedure may prolong disease free survival in patients with acute myeloid leukemia (AML). Autologous SCT is increasingly used as treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous SCT for patients with AML in first remission treated by autologous SCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen.
Between January 1995 and December 1999, 29 patients with AML in first remission underwent autologous SCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine (3.0 gm/m2 for 3 days), melphalan (100 mg/m2 for 1 day) and TBI (total 1000 cGy in five fractions over 3 days).
The median follow up was 40 months with a range of 3 to 58 months. The 4-year cumulative probability of disease free survival was 69.0%, and median survival was 41.5 months. The 4-year relapse rate was 27.6%. The factor influencing disease free survival and relapse rate was the French-American-British (FAB) classification (M3 group vs. other groups; p=0.048, p=0.043). One patient died from treatment-related toxicity.
Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBI as a conditioning regimen for autologous SCT for AML in first remission appears to be safe and effective.
Key Words: AML, Autologous stem cell transplantation, Total body irradiation
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