Fludarabine, treosulfan and etoposide sensitivity and the outcome of hematopoietic stem cell transplantation in childhood acute myeloid leukemia

Styczynski, J.; Toporski, J.; Wysocki, M.; Debski, R.; Chybicka, A.; Boruczkowski, D.; Wachowiak, J.; Wojcik, B.; Kowalczyk, J.; Gil, L.; Balwierz, W.; Matysiak, M.; Krawczuk-Rybak, M.; Balcerska, A.; Sonta-Jakimczyk, D.

Anticancer Research 27(3b): 1547-1551

2007


ISSN/ISBN: 0250-7005
PMID: 17595774
Document Number: 614902
Background: The prognostic role of the ex vivo drug resistance profile has not yet been proved in childhood acute myeloid leukemia (AML). The aim of the study was the analysis of the impact of the ex vivo drug resistance profile in a cohort of 44 children with AML undergoing hematopoietic stem cell transplantation (HSCT). Patients and Methods: Myeloblasts for drug resistance testing were obtained from the bone marrow either on diagnosis or at relapse, before the HSCT procedure and were tested by the MTT assay. Results: Children who relapsed after transplantation showed higher ex vivo resistance of the leukemic blasts to etoposide, mercaptopurine, thioguanine, fludarabine, mitoxantrone and treosulfan than those who stayed in remission. Despite being nondiscriminative, the combined ex vivo drug resistance profile to fludarabine, treosulfan and etoposide (FTE score) was the strongest prognostic factor by multivariate analysis. Conclusion: The combined drug resistance profile to fludarabine, treosulfan and etoposide may be useful for better stratification of children with AML undergoing stem cell transplantation or to indicate the necessity for additional post-transplant therapy.

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