Intensive Sequential Chemotherapy with Etoposide, Mitoxantrone and Ctarabine (EMA) as Salvage in Patients with Acute Myeloid Leukemia Relapsing After Allogeneic Stem Cell Transplantation a Retrospective Analysis

alınama-ABSTRACT Objective: Disease relapse following allogeneic stem cell transplantation which depends on the type of the disease and the status at the time of procedure, remains the major cause of treatment failure in patients with acute myeloid leukemia (AML). The optimal treatment strategy for patients with AML relapsing after stem cell transplantation remains contraversial and the prognosis is generally poor. We retrospectively analysed the efficacy of intensive sequential chemoterapy with etoside, mitoxantrone and cytarabine (EMA) to achieve remission in patients with AML relapsing after allogeneic stem cell transplantation in our hematology department. Patients and Methods: Sixteen AML patients relapsing after allogeneic stem cell transplantation who were treated with EMA chemoterapy between 2015-2018 were analysed retrospectively. Results: Complete remission was achieved in 7 (43.7%) of 16 patients. All patients suffered grade 4 neutropenia, thrombocytopenia and neutropenic fever. Five (31.3%) patients were died during treatment due to infection. Further treatment with donor cell based therapies was given in seven patients who achieved complete remission after EMA. One-year survival rates in responding patients was %57. Conclusion: Long term survival can be achieved with donor cell based treatment strategy in patients with AML relapsing after stem cell transplantation. Induction of complete remission with cytoreductive therapy can influence the survival of patients who are suitable for intensive therapy. Intensive sequential EMA chemoterapy is an efficacious option to induce remission in theese patients.