Reduced-Intensity Conditioning with Busulfan and Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Lymphoblastic Leukemia
10.3349/ymj.2020.61.6.452
- Author:
Seung-Shin LEE
1
;
Sung-Hoon JUNG
;
Young Rok DO
;
Dae Sik KIM
;
Ji Hyun LEE
;
Han-Seung PARK
;
Joon Ho MOON
;
Jun Ho YI
;
Yong PARK
;
Youngil KOH
;
Ho-Young YHIM
;
Yunsuk CHOI
;
Yeung-Chul MUN
;
Won-Sik LEE
;
Seok LEE
;
Deok-Hwan YANG
;
Author Information
1. Department of Hematology and Oncology, Wonkwang University Hospital, Iksan, Korea
- Publication Type:Original Article
- From:Yonsei Medical Journal
2020;61(6):452-459
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Allogeneic hematopoietic stem cell transplantation (HSCT) with optimal conditioning has helped better long-term survival in acute lymphoblastic leukemia (ALL). This study investigated the efficacy and safety of reduced-intensity conditioning (RIC) with busulfan and fludarabine in adult ALL patients unfit for myeloablation.
Materials and Methods:Records of 78 patients who underwent HSCT with RIC consisting of 3.2 mg/kg/day of busulfan for 2 or 3 days and 30 mg/m2/day of fludarabine for 5 or 6 days were analyzed.
Results:The median age at diagnosis was 49 years. Over a median follow-up of 22 months, 2-year estimates of relapse-free survival (RFS) and overall survival were 57.4% and 68.7%, respectively. Multivariate analysis showed a trend of improved RFS in patients with chronic graft-versus-host disease (GVHD) (hazard ratio, 0.53; 95% confidence interval, 0.26–1.08; p=0.080). The cumulative incidences of relapse and non-relapse mortality were 42.9% and 19.6%, respectively and one case of central nervous system relapse was noted. No hepatic veno-occlusive disease was reported. Grade II–IV acute GVHD and any grade chronic GVHD occurred in 21.1% and 41.7%, respectively.
Conclusion:RIC with busulfan and fludarabine is an effective and safe conditioning regimen for adult ALL patients unfit for myeloablation.
