Allogenic versus autologous stem cell transplantation in adult acute myeloid leukemia patients with normal cytogenetics and FLT3 negative state / Hossam Eldeen Ahmed Elashtokhy ; Supervised Hossam Mohamed Kamel , Mohamed Abdelmooti Mohamed , Yasser Hassan Elnahas

Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Medical Oncology

Introduction: Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by clonal expansion of myeloid blasts in the peripheral blood (PB), bone marrow (BM) and/or other tissues. Stem cell transplantation (SCT) represents the only curative therapy for intermediate- and high-risk AML. Aim of the Work: To compare allogenic with autologous peripheral blood SCT (PBSCT) in adult normal karyotype (NK)-AML patients with FLT3 negative state regarding toxicities of transplant procedure, transplant-related mortality (TRM), diseases-free survival (DFS), and overall survival (OS).Results: Forty-three patients with the previously mentioned eligibility criteria were included & followed up in this study during the period from January 2011 to December 2014. For the whole group, the median age was 29 years. Thirty-four patients underwent allogeneic SCT while the remaining 9 patients underwent autologous SCT. After a median follow up of 21.5 months (0.3{u2013} 46.5), the cumulative 2-year OS and DFS in the allogeneic group were 73.5% and 70.6% respectively, compared to 74.1% and 64.8% respectively in the autologous group with no statistically significant difference in OS and DFS between the two transplant groups (p = 0.690 and 0.768 respectively). Conclusion: The above-mentioned data in our study showed non-inferiority of autologous compared to allogenic SCT in this category of patients. To confirm these results, larger studies are needed, with inclusion of a third arm (consolidation with chemotherapy), and new emerging molecular markers for better choice of the type of consolidation treatment.

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