2006Pediatric Blood & CancerRequires access

The outcome of children with acute myeloid leukemia (AML) post‐allogeneic stem cell transplantation (SCT) is not improved by the addition of etoposide to the conditioning regimen

Mouhab Fakhreddine Ayas, Amal Al‐Seraihi, M Al-Mahr, Abdullah Al‐Jefri, Assim Belgaumi, Ibrahim M. Elhassan, Hassan El‐Solh

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Abstract

BACKGROUND: Relapse remains a concern for children with AML undergoing allogeneic SCT, so in an effort to reduce the risk of relapse in these patients, we intensified our pre-SCT preparation by adding etoposide to the standard busulfan and cyclophosphamide regimen. PROCEDURE: We retrospectively analyzed the collected data and compared the two groups; Group A (n = 18) included patients who received busulfan 16 mg/kg plus cyclophosphamide 200 mg/kg (Bu/Cy), and Group B (n = 48) included patients who received busulfan 12 mg/kg, cyclophosphamide 90 mg/kg in addition to etoposide 60 mg/kg (Bu/Cy/VP). The patients' characteristics were similar in the two groups. RESULTS: No significant difference in the overall outcome was noted; the 5-year overall survival was 50% and 53.3% for Groups A and B, respectively (P = 0.9). Similarly, the 5-year probability of relapse was 64.1% and 46.1% for Groups A and B, respectively (P = 0.38). The use of etoposide was not associated with increased toxicity. CONCLUSION: The addition of etoposide to the Bu/Cy regimen was well tolerated, but did not appear to improve the outcome.

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What this paper is about

BACKGROUND: Relapse remains a concern for children with AML undergoing allogeneic SCT, so in an effort to reduce the risk of relapse in these patients, we intensified our pre-SCT preparation by adding etoposide to the standard busulfan and cyclophosphamide regimen. PROCEDURE: We retrospectively analyzed the collected data and compared the two groups; Group A (n = 18) included patients who received busulfan 16 mg/kg plus cyclophosphamide 200 mg/kg (Bu/Cy), and Group B (n = 48) included patients who received busulfan 12 mg/kg, cyclophosphamide 90 mg/kg in addition to etoposide 60 mg/kg (Bu/Cy/VP). The patients' characteristics were similar in the two groups. RESULTS: No significant difference in the overall outcome was noted; the 5-year overall survival was 50% and 53.3% for Groups A and B, respectively (P = 0.9). Similarly, the 5-year probability of relapse was 64.1% and 46.1% for Groups A and B, respectively (P = 0.38). The use of etoposide was not associated with increased toxicity. CONCLUSION: The addition of etoposide to the Bu/Cy regimen was well tolerated, but did not appear to improve the outcome.

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Available abstract

BACKGROUND: Relapse remains a concern for children with AML undergoing allogeneic SCT, so in an effort to reduce the risk of relapse in these patients, we intensified our pre-SCT preparation by adding etoposide to the standard busulfan and cyclophosphamide regimen. PROCEDURE: We retrospectively analyzed the collected data and compared the two groups; Group A (n = 18) included patients who received busulfan 16 mg/kg plus cyclophosphamide 200 mg/kg (Bu/Cy), and Group B (n = 48) included patients who received busulfan 12 mg/kg, cyclophosphamide 90 mg/kg in addition to etoposide 60 mg/kg (Bu/Cy/VP). The patients' characteristics were similar in the two groups. RESULTS: No significant difference in the overall outcome was noted; the 5-year overall survival was 50% and 53.3% for Groups A and B, respectively (P = 0.9). Similarly, the 5-year probability of relapse was 64.1% and 46.1% for Groups A and B, respectively (P = 0.38). The use of etoposide was not associated with increased toxicity. CONCLUSION: The addition of etoposide to the Bu/Cy regimen was well tolerated, but did not appear to improve the outcome.

Key concepts: Busulfan, Etoposide, Medicine, Cyclophosphamide, Regimen, Internal medicine, Transplantation, Gastroenterology

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The outcome of children with acute myeloid leukemia (AML) post‐allogeneic stem cell transplantation (SCT) is not improved by the addition of etoposide to the conditioning regimen — Research Paper | ScholarLens