A Preliminary Report of Busulfan, Melphalan and Thiotepa or TBI-containing Bi-alkylator Chemotherapy as a Preparative Regimen for Allogeneic Bone Marrow Transplantation in Refractory or Relapsed Acute Leukemias.
- Author:
Hee Je KIM
1
;
Woo Sung MIN
;
Sung Kyu PARK
;
Dong Wook KIM
;
Jong Wook LEE
;
Chi Hwa HAN
;
Chun Choo KIM
;
Dong Jip KIM
Author Information
1. Catholic BMT Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Refractory and Relapsed leukemia;
Busulfan;
Melphalan;
Thiotepa;
Allogeneic BMT;
PBPCs
- MeSH:
Adult;
Bone Marrow Transplantation*;
Bone Marrow*;
Busulfan*;
Drug Therapy*;
Granulocyte Colony-Stimulating Factor;
Humans;
Leukemia*;
Leukemia, Myeloid, Acute;
Melphalan*;
Precursor Cell Lymphoblastic Leukemia-Lymphoma;
Sepsis;
Stem Cell Transplantation;
Stem Cells;
Stomatitis;
Thiotepa*
- From:Journal of the Korean Cancer Association
1997;29(5):874-885
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We assessed the three-alkylator combination of busulfan, melphalan and thiotepa or TBI, melphalan and thiotepa conditioning for allogeneic stem cell transplantation in 7 adult patients with refractory or relapsed acute leukemias. MATERIALS AND METHODS: Six patients were transplanted for acute myeloid leukemia, one for acute lymphoblastic leukemia and included 5 of relapsed refractory, 2 of relapsed after first-BMT. All but 1 cases received G-CSF stimulated CD34+ allogeneic peripheral blood progenitor cells (PBPCs) in addition to stimulated allogeneic marrow. RESULTS: All patients except one engrafted (median time to ANC >0.5 10 (9)/L=11days, to platelets >30 X 10 (9)/L=14 days) successfully and complete remission was obtained in 6 patients. Grade I-II acute GVHD and controllable regimen-related toxicity especially oral mucositis (grade II-III) developed in all cases, but 2 patients including one second- allogeneic BMT patient expired early by transplant-related toxicity of hepatic or multiorgan failure along the course of sepsis. CONCLUSION: Although the observation period on these cases are limited, the data presented show that the combination of busulfan, melphalan and thiotepa is tolerable as a preparative regimen for allogeneic marrow transplantation in high-risk leukemic patients. We think that these encouraging results need to be confirmed in prospective studies in the future.
