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Stem Cell Transplantation Followed by Cytarabine Chemotherapy for AML

By: Kelly M. Hennessey, PhD
Posted: Wednesday, November 4, 2020

A high-dose regimen of cytarabine prior to hematopoietic stem cell transplantation seemed to improve disease-free progression, overall survival, and the incidence of relapse in patients with acute myeloid leukemia (AML) in their first complete remission. Akifumi Takaori-Kondo, MD, PhD, of Kyoto University, Japan, and colleagues conducted a study between January 2005 and December 2016 and examined the details of chemotherapeutic regimens. The results of their study were published in Leukemia & Lymphoma.

This retrospective study analyzed data from patients with AML who achieved their first complete remission after one or two cycles of chemotherapy prior to allogenic stem cell transplantation. Patients were categorized based on whether or not they received high-dose cytarabine (≥ 4 g/m2/day). Researchers also compared patient outcomes between those who were administered a standard dose (< 1 g/m2/day) or an intermediate dose (a daily dose in between the standard and high doses) and those who received high-dose cytarabine. A total of 111 patients in first complete remission who then underwent hematopoietic stem cell transplantation were included in the original analysis. However, patients with at least two cycles of chemotherapy or those with a high hematopoietic cell transplantation comorbidity index (score ≥ 3) were excluded. Additionally, because age is a factor in disease-free and overall survival, the final analysis included only patients between 20 and 61 years (n = 79).

Of the 79 patients, 54 patients achieved complete remission after the first round of chemotherapy, and the remaining 25 patients achieved complete remission after the second round. Disease-free survival and overall survival of patients who received one round of high-dose cytarabine were similar to those of patients who received more than one cycle.

“At least one cycle of high-dose cytarabine (≥ 4 g/m2/day) before allosteric hematopoietic stem cell transplant has the potential to improve outcomes of patients with AML,” concluded the researchers.

Disclosure: The study authors reported no conflicts of interest.


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