Peripheral Blood Stem Cell Collection after Intermediate-Dose Cytarabine in Adult Patients with Acute Myeloblastic Leukemia Undergoing Autologous Blood Stem Cell Transplantation in First Complete Remission

Different strategies for collecting peripheral blood stem cells (PBSC) for autologous blood stem cell transplantation (ABSCT) have been reported for patients with acute myeloblastic leukemia (AML). We compared the clinical results of 2 consecutive protocols in 75 adult patients with AML in first complete remission who underwent ABSCT. In the first 56 patients (group A), PBSC were collected after induction and/or consolidation chemotherapy courses. In the subsequent 19 patients (group B), PBSC collection was done after a further intensification course with intermediate-dose cytarabine and mitoxantrone. Hematopoietic engraftment was similar in the 2 groups, with the median times to reach 0.5 x 10(9) neutrophils/L and 20 x 10(9) platelets/L being 13 days each in group A, and 12 days and 24 days, respectively, in group B. There were 3 graft failures (all in group A) and 5 transplantation-related deaths (6.6%, 4 in group A and 1 in group B). Although not statistically significant, the 3-year probabilities of both relapse (31% versus 66%; P = .12) and disease-free survival (60% versus 36%; P = .1) compared favorably for group B. Our study suggests that collection of PBSC after additional intensification can result in a better outcome for AML patients who undergo ABSCT.