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[A comparison of toxicity and efficacy between busulfan plus fludarabine and busulfan plus cyclophosphamide for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia].
Zhonghua Nei Ke Za Zhi. 2012 Nov; 51(11):880-4.ZN

Abstract

OBJECTIVE

To compare the transplant-related toxicity and the efficacy of busulfan/fludarabine (Bu/Flu) and busulfan/cyclophosphamide (Bu/Cy) as conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia(AML) in the first complete remission (CR1).

METHODS

Totally 32 AML-CR1 patients underwent allo-HSCT were divided into Bu/Cy (Bu 3.2 mg×kg(-1)×d(-1), 7 - 4 days before transplantation; Cy 60 mg×kg(-1)×d(-1), 3 - 2 days before transplantation) and Bu/Flu (Bu 3.2 mg×kg(-1)×d(-1), 5 - 2 days before transplantation; Flu 30 mg×m(-2)×d(-1), 6 - 2 days before transplantation) groups. The regimen-related toxicity (RRT), incidence and severity of graft-versus-host disease (GVHD), 3-year cumulative relapse rate, non-relapse mortality (NRM), 3-year event-free survival (EFS) rate and overall survival (OS) rate were compared between the two groups.

RESULTS

The median follow-up duration was 617.5 (6 - 1261) days. All patients achieved successful engraftment on 30 day after transplantation. There were no significant differences in the median time to neutrophil engraftment (P = 0.121) and platelet engraftment (P = 0.171) between the two groups. The median duration of neutrophil count under 0.1×10(9)/L and platelet count under 20×10(9)/L in the Bu/Cy group were significantly longer than those in the Bu/Flu group (P = 0.000 and P = 0.047). The incidence of grades II-IV RRT were 68.8% and 25.0% (P = 0.032) in the Bu/Cy and the Bu/Flu groups, respectively. There were no significant differences in the incidence of acute GVHD (P = 0.149), chronic GVHD (P = 0.149), incidence of NRM (P = 0.333), 3-year cumulative relapse rates (P = 0.834), 3-year EFS rate (P = 0.362) and OS rate (P = 0.111) between the two groups.

CONCLUSION

Compared with Bu/Cy, Bu/Flu is a myeloablative condition regimen with milder bone marrow suppression and lower RRT incidence rate in allogeneic HSCT for AML-CR1 patients without compromising the efficacy.

Authors+Show Affiliations

Institute of Hematology, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China.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 available

Pub Type(s)

Comparative Study
English Abstract
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

chi

PubMed ID

23291027

Citation

Liu, Hui, et al. "[A Comparison of Toxicity and Efficacy Between Busulfan Plus Fludarabine and Busulfan Plus Cyclophosphamide for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia]." Zhonghua Nei Ke Za Zhi, vol. 51, no. 11, 2012, pp. 880-4.
Liu H, Fan ZP, Jiang QL, et al. [A comparison of toxicity and efficacy between busulfan plus fludarabine and busulfan plus cyclophosphamide for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia]. Zhonghua Nei Ke Za Zhi. 2012;51(11):880-4.
Liu, H., Fan, Z. P., Jiang, Q. L., Huang, F., Zhou, H. S., Zhang, X., Yu, G. P., Wu, M. Q., Sun, J., & Liu, Q. F. (2012). [A comparison of toxicity and efficacy between busulfan plus fludarabine and busulfan plus cyclophosphamide for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia]. Zhonghua Nei Ke Za Zhi, 51(11), 880-4.
Liu H, et al. [A Comparison of Toxicity and Efficacy Between Busulfan Plus Fludarabine and Busulfan Plus Cyclophosphamide for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia]. Zhonghua Nei Ke Za Zhi. 2012;51(11):880-4. PubMed PMID: 23291027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A comparison of toxicity and efficacy between busulfan plus fludarabine and busulfan plus cyclophosphamide for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia]. AU - Liu,Hui, AU - Fan,Zhi-ping, AU - Jiang,Qian-li, AU - Huang,Fen, AU - Zhou,Hong-sheng, AU - Zhang,Xian, AU - Yu,Guo-pan, AU - Wu,Mei-qing, AU - Sun,Jing, AU - Liu,Qi-fa, PY - 2013/1/8/entrez PY - 2013/1/8/pubmed PY - 2013/11/2/medline SP - 880 EP - 4 JF - Zhonghua nei ke za zhi JO - Zhonghua Nei Ke Za Zhi VL - 51 IS - 11 N2 - OBJECTIVE: To compare the transplant-related toxicity and the efficacy of busulfan/fludarabine (Bu/Flu) and busulfan/cyclophosphamide (Bu/Cy) as conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia(AML) in the first complete remission (CR1). METHODS: Totally 32 AML-CR1 patients underwent allo-HSCT were divided into Bu/Cy (Bu 3.2 mg×kg(-1)×d(-1), 7 - 4 days before transplantation; Cy 60 mg×kg(-1)×d(-1), 3 - 2 days before transplantation) and Bu/Flu (Bu 3.2 mg×kg(-1)×d(-1), 5 - 2 days before transplantation; Flu 30 mg×m(-2)×d(-1), 6 - 2 days before transplantation) groups. The regimen-related toxicity (RRT), incidence and severity of graft-versus-host disease (GVHD), 3-year cumulative relapse rate, non-relapse mortality (NRM), 3-year event-free survival (EFS) rate and overall survival (OS) rate were compared between the two groups. RESULTS: The median follow-up duration was 617.5 (6 - 1261) days. All patients achieved successful engraftment on 30 day after transplantation. There were no significant differences in the median time to neutrophil engraftment (P = 0.121) and platelet engraftment (P = 0.171) between the two groups. The median duration of neutrophil count under 0.1×10(9)/L and platelet count under 20×10(9)/L in the Bu/Cy group were significantly longer than those in the Bu/Flu group (P = 0.000 and P = 0.047). The incidence of grades II-IV RRT were 68.8% and 25.0% (P = 0.032) in the Bu/Cy and the Bu/Flu groups, respectively. There were no significant differences in the incidence of acute GVHD (P = 0.149), chronic GVHD (P = 0.149), incidence of NRM (P = 0.333), 3-year cumulative relapse rates (P = 0.834), 3-year EFS rate (P = 0.362) and OS rate (P = 0.111) between the two groups. CONCLUSION: Compared with Bu/Cy, Bu/Flu is a myeloablative condition regimen with milder bone marrow suppression and lower RRT incidence rate in allogeneic HSCT for AML-CR1 patients without compromising the efficacy. SN - 0578-1426 UR - https://www.unboundmedicine.com/medline/citation/23291027/[A_comparison_of_toxicity_and_efficacy_between_busulfan_plus_fludarabine_and_busulfan_plus_cyclophosphamide_for_allogeneic_hematopoietic_stem_cell_transplantation_in_acute_myeloid_leukemia]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0578-1426&year=2012&vol=51&issue=11&fpage=880 DB - PRIME DP - Unbound Medicine ER -