H e m a t o lo g y E d u c a t io n - European Hematology Association

After allogeneic HSCT, an autologous transplant is
possibly the most potent form of post-remission therapy;
in this instance, relying solely on the anti-leukemic
effect provided by the myeloablative conditioning.
Autologous HSCT is therefore an alternative to allogeneic
HSCT in CR2, particularly in those patients with
a longer first remission. A recent report demonstrated a
5-year OS of 32% in adult patients with relapsed intermediate
or good-risk cytogenetics autografted in CR2
and who had a first remission of more than 8 months. 52
The outcome was improved by the use of grafts
obtained in CR1 and use of PBSC rather than BM. 52
Excellent results with autologous transplant have also
been obtained in APL in CR2 for patients who have
achieved a molecular CR following re-induction therapy
and who have a graft that is also PCR negative. 53–55 For
APL patients not in molecular remission or with a short
CR1, an allogeneic HSCT is recommended. 54
References
1. Burnett AK, Wheatley K, Goldstone AH, et al. The value of
allogeneic bone marrow transplant in patients with acute
myeloid leukemia at differing risk of relapse: results of the UK
MRC AML10 Trial. Br J Haematol. 2002;118:385-400.
2. Suciu S, Mandelli F, De Witte T, et al. Allogeneic compared to
autologous stem cell transplantation in the treatment of
patients