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Feasibility of non-TBI conditioning with busulfan and fludarabine for allogeneic stem cell transplantation in lymphoid malignancy.
Korean J Intern Med. 2012 Mar; 27(1):72-83.KJ

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.

Authors+Show Affiliations

Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22403503

Citation

Shin, Ho Cheol, et al. "Feasibility of non-TBI Conditioning With Busulfan and Fludarabine for Allogeneic Stem Cell Transplantation in Lymphoid Malignancy." The Korean Journal of Internal Medicine, vol. 27, no. 1, 2012, pp. 72-83.
Shin HC, Lee YJ, Moon JH, et al. Feasibility of non-TBI conditioning with busulfan and fludarabine for allogeneic stem cell transplantation in lymphoid malignancy. Korean J Intern Med. 2012;27(1):72-83.
Shin, H. C., Lee, Y. J., Moon, J. H., Lee, S. J., Kang, B. W., Chae, Y. S., Kim, J. G., Choi, J. Y., Seo, J. W., Kim, Y. K., Suh, J. S., & Sohn, S. K. (2012). Feasibility of non-TBI conditioning with busulfan and fludarabine for allogeneic stem cell transplantation in lymphoid malignancy. The Korean Journal of Internal Medicine, 27(1), 72-83. https://doi.org/10.3904/kjim.2012.27.1.72
Shin HC, et al. Feasibility of non-TBI Conditioning With Busulfan and Fludarabine for Allogeneic Stem Cell Transplantation in Lymphoid Malignancy. Korean J Intern Med. 2012;27(1):72-83. PubMed PMID: 22403503.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of non-TBI conditioning with busulfan and fludarabine for allogeneic stem cell transplantation in lymphoid malignancy. AU - Shin,Ho Cheol, AU - Lee,Yoo Jin, AU - Moon,Joon Ho, AU - Lee,Soo Jung, AU - Kang,Byung Woog, AU - Chae,Yee Soo, AU - Kim,Jong Gwang, AU - Choi,Jun Young, AU - Seo,Jong Won, AU - Kim,Yu Kyung, AU - Suh,Jang Soo, AU - Sohn,Sang Kyun, Y1 - 2012/02/28/ PY - 2011/06/14/received PY - 2011/08/24/revised PY - 2011/11/16/accepted PY - 2012/3/10/entrez PY - 2012/3/10/pubmed PY - 2012/7/10/medline KW - Busulfan KW - Drug therapy KW - Fludarabine KW - Precursor cell lymphoblastic leukemia-lymphoma SP - 72 EP - 83 JF - The Korean journal of internal medicine JO - Korean J Intern Med VL - 27 IS - 1 N2 - 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. SN - 2005-6648 UR - https://www.unboundmedicine.com/medline/citation/22403503/Feasibility_of_non_TBI_conditioning_with_busulfan_and_fludarabine_for_allogeneic_stem_cell_transplantation_in_lymphoid_malignancy_ L2 - https://dx.doi.org/10.3904/kjim.2012.27.1.72 DB - PRIME DP - Unbound Medicine ER -