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New myeloablative conditioning regimen with fludarabine and busulfan for allogeneic stem cell transplantation: comparison with BuCy2.
Bone Marrow Transplant. 2007 Sep; 40(6):541-7.BM

Abstract

A regimen of busulfan and cyclophosphamide (BuCy2) is regarded as the standard myeloablative regimen for SCT. This study evaluated the hypothesis that fludarabine can replace cyclophosphamide for myeloablative allogeneic SCT. Ninety-five patients underwent allogeneic SCT from HLA-identical donors, following BuCy2 (n=55) or busulfan+fludarabine (BF, n=40). The efficacy of fludarabine compared to cyclophosphamide was retrospectively evaluated. The BF group exhibited a shorter duration until engraftment (P=0.001), lower incidence of acute and chronic GVHD (P<0.001 and P=0.003, respectively), and non-relapse mortality (NRM) (P=0.039). Furthermore, the event-free survival and overall survival were significantly higher for the BF group compared to the BuCy2 group (P=0.004 and 0.002, respectively). After adjusting for age, the risk status of disease, GVHD prophylaxis and donor type, the BF regimen was found to be an independent favorable risk factor for event-free survival (hazard ratio (HR), 0.181; 95% confidence interval, 0.045-0.720; P=0.016) and overall survival (HR, 0.168; 0.035-0.807; P=0.026). The replacement of cyclophosphamide with fludarabine for myeloablative conditioning seems to be more effective in terms of short-term NRM, and GVHD compared to BuCy2 regimen in allogeneic transplantation.

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Authors+Show Affiliations

Chae YS
1Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea.
Sohn SK
No affiliation info available
Kim JG
No affiliation info available
Cho YY
No affiliation info available
Moon JH
No affiliation info available
Shin HJ
No affiliation info available
Chung JS
No affiliation info available
Cho GJ
No affiliation info available
Yang DH
No affiliation info available
Lee JJ
No affiliation info available
Kim YK
No affiliation info available
Kim HJ
No affiliation info available

MeSH

AdolescentAdultArterial Occlusive DiseasesBusulfanCyclophosphamideCytomegalovirus InfectionsDisease-Free SurvivalFemaleGraft vs Host DiseaseHematopoietic Stem Cell TransplantationHumansIncidenceLeukemiaMaleMiddle AgedMyeloablative AgonistsRecurrenceRetrospective StudiesRisk FactorsSurvival RateTransplantation ConditioningTransplantation, HomologousVidarabine

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

17637692

Citation

Chae, Y S., et al. "New Myeloablative Conditioning Regimen With Fludarabine and Busulfan for Allogeneic Stem Cell Transplantation: Comparison With BuCy2." Bone Marrow Transplantation, vol. 40, no. 6, 2007, pp. 541-7.
Chae YS, Sohn SK, Kim JG, et al. New myeloablative conditioning regimen with fludarabine and busulfan for allogeneic stem cell transplantation: comparison with BuCy2. Bone Marrow Transplant. 2007;40(6):541-7.
Chae, Y. S., Sohn, S. K., Kim, J. G., Cho, Y. Y., Moon, J. H., Shin, H. J., Chung, J. S., Cho, G. J., Yang, D. H., Lee, J. J., Kim, Y. K., & Kim, H. J. (2007). New myeloablative conditioning regimen with fludarabine and busulfan for allogeneic stem cell transplantation: comparison with BuCy2. Bone Marrow Transplantation, 40(6), 541-7.
Chae YS, et al. New Myeloablative Conditioning Regimen With Fludarabine and Busulfan for Allogeneic Stem Cell Transplantation: Comparison With BuCy2. Bone Marrow Transplant. 2007;40(6):541-7. PubMed PMID: 17637692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New myeloablative conditioning regimen with fludarabine and busulfan for allogeneic stem cell transplantation: comparison with BuCy2. AU - Chae,Y S, AU - Sohn,S K, AU - Kim,J G, AU - Cho,Y Y, AU - Moon,J H, AU - Shin,H J, AU - Chung,J S, AU - Cho,G J, AU - Yang,D H, AU - Lee,J-J, AU - Kim,Y-K, AU - Kim,H-J, Y1 - 2007/07/16/ PY - 2007/7/20/pubmed PY - 2007/12/6/medline PY - 2007/7/20/entrez SP - 541 EP - 7 JF - Bone marrow transplantation JO - Bone Marrow Transplant. VL - 40 IS - 6 N2 - A regimen of busulfan and cyclophosphamide (BuCy2) is regarded as the standard myeloablative regimen for SCT. This study evaluated the hypothesis that fludarabine can replace cyclophosphamide for myeloablative allogeneic SCT. Ninety-five patients underwent allogeneic SCT from HLA-identical donors, following BuCy2 (n=55) or busulfan+fludarabine (BF, n=40). The efficacy of fludarabine compared to cyclophosphamide was retrospectively evaluated. The BF group exhibited a shorter duration until engraftment (P=0.001), lower incidence of acute and chronic GVHD (P<0.001 and P=0.003, respectively), and non-relapse mortality (NRM) (P=0.039). Furthermore, the event-free survival and overall survival were significantly higher for the BF group compared to the BuCy2 group (P=0.004 and 0.002, respectively). After adjusting for age, the risk status of disease, GVHD prophylaxis and donor type, the BF regimen was found to be an independent favorable risk factor for event-free survival (hazard ratio (HR), 0.181; 95% confidence interval, 0.045-0.720; P=0.016) and overall survival (HR, 0.168; 0.035-0.807; P=0.026). The replacement of cyclophosphamide with fludarabine for myeloablative conditioning seems to be more effective in terms of short-term NRM, and GVHD compared to BuCy2 regimen in allogeneic transplantation. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/17637692/New_myeloablative_conditioning_regimen_with_fludarabine_and_busulfan_for_allogeneic_stem_cell_transplantation:_comparison_with_BuCy2_ L2 - http://dx.doi.org/10.1038/sj.bmt.1705770 DB - PRIME DP - Unbound Medicine ER -
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