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Autologous Transplantation in 1^st Cr Aml Patients with Purged or Unpurged Bone Marrow: Good Clinical Results in Favorable Cytogenetic Group and in those Infused with a Low Number of Marrow Cells

Salvatore Leotta, Salvatore Mercurio, Carla Consoli, Alessandra Cupri, Maria Grazia Camuglia, Giuseppe Avola, Andrea Spadaro, Paolo Spina, Marina Parisi, Deja Berritta and Giuseppe Milone

In a single institution, 31 patients affected with Acute Myeloid Leukaemia (AML) in 1st Complete Remission (CR) received autologous bone marrow transplantation (ABMT). Mafosfamide was employed in a non-randomized fashion to purge marrows, in 15 cases bone marrow cells were purged, while in 16 they were left unpurged. Dose of infused Total Nucleated Cells (TNC) was an important factor for myeloid engraftment (P=0.02). LFS was 58% in purged and 40% in unpurged groups (P=0.26). Patients having a good prognosis cariotype had a LFS of 100% while the group of all other patients had a LFS of 37.5%. Patients receiving a dose of TNC below to median had a LFS of 65% and those receiving a dose of TNC>median had a LFS of 28% (P=0.017). Purging significantly improved LFS in patients “not harbouring good cytogenetic abnormalities” (53% LFS in purged group versus 18% in unpurged group, P=0.05). In conclusion, ABMT is associated with excellent results in “good prognosis cytogenetic”. Purging may improve results in patients belonging to “intermediate cytogenetic group”. A high number of infused TNC produces a fast myeloid engraftment but a poor LFS.