Fludarabine-based myeloablative regimen as pretransplant conditioning therapy in adult acute leukemia/myelodysplastic syndrome: comparison with oral or intravenous busulfan with cyclophosphamide.
10.5045/kjh.2010.45.2.102
- Author:
Ji Hyun LEE
1
;
Jimin CHOI
;
Kyung A KWON
;
Suee LEE
;
Sung Yong OH
;
Hyuk Chan KWON
;
Hyo Jin KIM
;
Jin Yeong HAN
;
Sung Hyun KIM
Author Information
1. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. kshmoon@dau.ac.kr
- Publication Type:Original Article
- Keywords:
Myeloablative regimen;
Allogeneic hematopoietic stem cell transplantation;
Fludarabine;
Busulfan
- MeSH:
Academic Medical Centers;
Adult;
Behavior Therapy;
Busulfan;
Cyclophosphamide;
Cystitis;
Disease-Free Survival;
Follow-Up Studies;
Graft vs Host Disease;
Hematopoietic Stem Cell Transplantation;
Hepatic Veno-Occlusive Disease;
Humans;
Incidence;
Leukemia;
Mucositis;
Myelodysplastic Syndromes;
Recurrence;
Retrospective Studies;
Vidarabine
- From:Korean Journal of Hematology
2010;45(2):102-108
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: A combination of busulfan (Bu) and cyclophosphamide (Cy) has been used as a standard myeloablative regimen for allogeneic hematopoietic stem cell transplantation (HSCT). Recent studies postulate that fludarabine (Flu) is a less toxic substitute for Cy. METHODS: Forty-two patients who were diagnosed with acute leukemia or myelodysplastic syndrome and received BuFlu (n=17) or BuCy (n=25) from August, 1999 to July, 2009 at Dong-A University Medical Center were retrospectively analyzed. RESULTS: The median follow-up duration was 39.75 months. The BuFlu group showed a lower incidence of mucositis (P=0.005), but there was no significant intergroup difference in the time of engraftment, nausea/vomiting, acute/chronic graft-versus-host disease, hepatic veno-occlusive disease, or hemorrhagic cystitis. Moreover, the 2 groups showed no significant difference in the cumulative risk of relapse, event-free survival, or overall survival. CONCLUSION: BuFlu administration can be employed as a preparative regimen for allogeneic HSCT and shows efficacy and transplant-adverse effects comparable to those of BuCy. However, randomized prospective studies in more patients are warranted.
