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Busulfan and melphalan as conditioning regimen for autologous hematopoietic stem cell transplantation in acute myeloid leukemia in first complete remission

Twenty-two consecutive patients with acute myeloid leukemia in first complete remission submitted to autologous hematopoietic stem cells transplantation conditioned with busulfan and melphalan were evaluated between 1993 and 2006. The overall survival, according to the Kaplan-Meier curve, was 57.5% at 36 months, with a "plateau" at 20 months after transplant. Factors such as gender, French-American-British (FAB) classification of acute myeloid leukemia, induction therapy, intensive consolidation, remission after the first cycle of induction and source of cells had no impact on survival. One patient with poor prognosis before the procedure died a year after transplantation. Nine patients died, eight by relapse and one because of bleeding. Death before 100 days occurred for two patients, one due to relapse and the other bleeding caused by refractory thrombocytopenia related to the procedure. In conclusion, the conditioning regiment with busulfan and melphalan is a valid option compared to the other conditioning regimens, with an excellent overall survival.

Hematopoietic stem cell transplantation; autologous transplantation; acute myeloid leukemia; mortality; toxicity of drugs


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