Feasibility of Non-TBI Conditioning with Busulfan and Fludarabine for Allogeneic Stem Cell Transplantation in Lymphoid Malignancy.
10.3904/kjim.2012.27.1.72
- Author:
Ho Cheol SHIN
1
;
Yoo Jin LEE
;
Joon Ho MOON
;
Soo Jung LEE
;
Byung Woog KANG
;
Yee Soo CHAE
;
Jong Gwang KIM
;
Jun Young CHOI
;
Jong Won SEO
;
Yu Kyung KIM
;
Jang Soo SUH
;
Sang Kyun SOHN
Author Information
1. Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea. sksohn@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Precursor cell lymphoblastic leukemia-lymphoma;
Busulfan;
Drug therapy;
Fludarabine
- MeSH:
Adolescent;
Adult;
Busulfan/adverse effects/*therapeutic use;
Chi-Square Distribution;
Disease-Free Survival;
Drug Therapy, Combination;
Feasibility Studies;
Female;
Graft vs Host Disease/etiology;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Multivariate Analysis;
Myeloablative Agonists/adverse effects/*therapeutic use;
Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/mortality/surgery/*therapy;
Proportional Hazards Models;
Republic of Korea;
Retrospective Studies;
Risk Assessment;
Risk Factors;
*Stem Cell Transplantation/adverse effects/mortality;
Time Factors;
Transplantation Conditioning/adverse effects/*methods/mortality;
Transplantation, Homologous;
Treatment Outcome;
Vidarabine/adverse effects/*analogs & derivatives/therapeutic use;
Young Adult
- From:The Korean Journal of Internal Medicine
2012;27(1):72-83
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: This retrospective study evaluated the transplantation outcomes of patients with adult lymphoid malignancies who received chemotherapy-based conditioning with busulfan and fludarabine (BuFlu) and busulfan and cyclophosphamide (BuCy2). METHODS: Thirty-eight patients (34 with acute lymphoblastic leukemia and 4 with lymphoblastic lymphoma) were included in the current study. The conditioning regimen was BuCy2 for 14 patients and BuFlu for the remaining 24 patients. Eight and 13 patients were high risk disease in the BuCy2 and BuFlu groups, respectively. RESULTS: The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 56.5% and 55.2% and that of extensive chronic GVHD 17.0% and 55.6% (p = 0.018) for the BuFlu and BuCy2 groups, respectively. The 3-year relapse rate was 27.8% and 31.4% and 3-year overall survival 34.3% and 46.8% for the BuFlu and BuCy2 groups, respectively. Treatment-related mortality (TRM) was significantly lower in the BuFlu group (16.9%) than in the BuCy2 group (57.1%, p = 0.010). In multivariate analyses, the BuFlu regimen was identified as an independent favorable risk factor for TRM (hazard ratio [HR], 0.036; p = 0.017) and extensive chronic GVHD (HR, 0.168; p = 0.034). CONCLUSIONS: Our BuFlu regimen would appear to be an acceptable conditioning option for lymphoid malignancies, including high-risk diseases. It was safely administered with a lower TRM rate than BuCy2 conditioning.
