The outcome of children with acute myeloid leukemia (AML) post-allogeneic stem cell transplantation (SCT) is not improved by the addition of etoposide to the conditioning regimen.

ABSTRACT

BACKGROUND: Relapse remains a concern for children with AML undergoing allogeneic SCT, so in an effort to reduce the risk of relapse in these patients, we intensified our pre-SCT preparation by adding etoposide to the standard busulfan and cyclophosphamide regimen. PROCEDURE We retrospectively analyzed the collected data and compared the two groups; Group A (n = 18) included patients who received busulfan 16 mg/kg plus cyclophosphamide 200 mg/kg (Bu/Cy), and Group B (n = 48) included patients who received busulfan 12 mg/kg, cyclophosphamide 90 mg/kg in addition to etoposide 60 mg/kg (Bu/Cy/VP). The patients' characteristics were similar in the two groups. RESULTS: No significant difference in the overall outcome was noted; the 5-year overall survival was 50% and 53.3% for Groups A and B, respectively (P = 0.9). Similarly, the 5-year probability of relapse was 64.1% and 46.1% for Groups A and B, respectively (P = 0.38). The use of etoposide was not associated with increased toxicity. CONCLUSION: The addition of etoposide to the Bu/Cy regimen was well tolerated, but did not appear to improve the outcome.