12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
to be added to B12 therapy in AIHA and DIC, respectively, for patients
to respond. In woman with MAHA and very high serum homocysteine,
112 µmol/L, B12 dose had to be doubled. After red cell transfusion, there
were a doubling of LDH in AIHA and an eightfold increase of D-dimer
in DIC. Conclusions. In CDA with greatly elevated serum LDH and low
normal folate further search for other causes of hemolysis is warranted.
AIHA, DIC and MAHA must be taken into account and when confirmed
a therapy modified.
Table 1. CDA with hemolysis related to other causes than B12 deficiency
alone.
1379
CLINICAL AND ECONOMIC INEFFICIENCY OF ROUTINELY HARVEST AUTOLOGOUS STEM
CELL AT FIRST COMPLETE REMISSION IN PATIENTS OF INTERMEDIATE AND HIGH RISK
AML
Y.M. Liao
China Medical University Hospital, TAICHUNG, Taiwan
Background. For patients of intermediate and high risk adult AML, the
relapse rate after standard induction and consolidation chemotherapy
remains high. Once relapse of AML developed and HLA-matched allogeneic
donor is not available, the treatment is limited and the outcome
is dismal. Autologous stem cell can be an alternative in this situation.
However, it is difficult to harvest autologous stem cell of good quality
when leukemia had already relapsed. Aims. To evaluate the feasibility of
routinely harvest and cryopreserved autologous peripheral blood stem
cell (APBSC) at first complete remission (CR) in patients of intermediate
and high risk AML and having no HLA-matched allogeneic donors.
Once relapse of AML developed, the patients may then receive autologous
transplantation. Methods. Patients of intermediate or high risk AML
and had no HLA-matched donors received conventional induction
chemotherapy (I3A7 regimen) followed by consecutive 2 courses of high
dose Ara-C (18g/sq.m in each course)/Mitoxantrone consolidation
chemotherapy (in-vivo purging). APBSCs were routinely collected
immediately after recovery from nadir phase of the second course consolidation
chemotherapy. At relapse, the patients were treated with high
dose chemotherapy or chemoradiotherapy followed by in vivo-purged
APBSCT. For patient with first CR longer than 1 year, another course of
salvage chemotherapy with high dose Ara-C will be given to induce
second CR. Results. Of the consecutive 26 patients enrolled, sufficient
APBSC (2 ? 106 /kg BW) was successfully harvested in 17 (65.4%) and the
result was not associated with age, gender, disease nature (intermediate
or high risk), lapse time between diagnosis and stem cell harvest, and
lapse time between second course consolidation chemotherapy and
stem cell harvest. However, a lower nadir white blood cell count (