Clinical Results Of Autologous Transplantation For Acute Myeloid Leukemia Phase II trials in AML

Numerous phase II trials have demonstrated the efficacy of ASCT as a consolidation therapy for AML in remission. Trials in second and subsequent remission generally demonstrate a 20-30% long-term RFS; studies in first remission show less uniform results, ranging from 34% to 70% long-term RFS. This likely depends largely upon quality of pre-transplant in vivo purging with chemotherapy and pre-treatment cytogenetics. Given that some studies suggest dramatic efficacy (RFS of up to 70%), caution must be used in interpreting these data. Additional factors that might influence how these results are interpreted include the duration between initial remission and transplant, baseline differences among patients likely to enter innovative trials (generally healthier and younger than historical controls), and variations in induction, consolidation, and preparative therapies. Lastly, most relapses following ASCT occur within first two years, and therefore adequate follow up prior to publication is necessary to avoid premature conclusions of efficacy.

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