A Comparison of Allogeneic and Autologous Hematopoietic Stem Cell Transplantation for Acute Myeloblastic Leukemia

Abstract

Introduction: Acute Myelogenous Leukemia (AML) is a clonal  malignant disease of hematopoietic tissue. The early use of  Hematopoietic Stem Cell Transplantation (HSCT) for AML was for patients with advanced stages of disease, usually while in relapse, in second or subsequent remission, or with resistant disease.
Patients and Methods: From March 1991 until February 2008, 356(65%) registered allogeneic transplantation and 192(35%) of  registered autologous transplantation had comprehensive data available for analysis and were included in this study and all patients have followed through January 2008.
Result: In allogeneic and autologous groups, 263 (73.9%) and 160 (88.3%) patients were in first complete remission, respectively. The stem cells sources of transplantation in allogeneic recipients were Peripheral Blood (92.4%), Bone Marrow (7%), Bone Marrow combined Peripheral Blood (0.3%) and Cord Blood (0.3%). The source of stem cell transplantation for 157 (82.3%) autologous patients was Peripheral Blood, for 33(17.2%) patients was Bone marrow and there was one recipient (0.5%) with combined Peripheral Blood and Bone marrow. Totally, 279 (78.4%) allogeneic patients and 123 (64.1%) autologous patients were alive since the end of this study. Relapse was the most common cause of death in both groups. Five years Overall Survival (OS) and Disease Free Survival (DFS) in allogeneic patients were 70.6% and 62.3% (SE=3%) and in autologous patients were 53.6% and 46.8% (SE=5%, 4%). The median follow up time for this study was 1.5 years (19 months).
Conclusion: According to this study and our experience, the acceptable treatment for Acute Myeloblastic Leukemia, especially in first complete remission is allogeneic Hematopoietic Stem Cell Transplantation.