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[Effect of BU and CY versus TBI and CY as conditioning regimens on the efficacy of haploidentical stem cell transplantation in patients with hematologic malignancy].
Zhonghua Xue Ye Xue Za Zhi. 2014 Jun; 35(6):505-10.ZX

Abstract

OBJECTIVE

To investigate the therapeutic effects of the conditioning regimen with busulfan plus cyclophosphamide (BU+CY) or total body irradiation plus cyclophosphamide (TBI+CY) on haploidentical stem cell transplantation (HSCT) in hematologic malignancy.

METHODS

The clinical outcomes of 77 HSCT recipients with hematologic malignancy from January 2001 to December 2010, including 21 AML, 33 ALL, 19 CML and 4 MDS were retrospectively evaluated. Among them, 65 patients obtained complete remission (CR) and 12 non-remission (NR) before transplantation; 39 patients received conditioning regimen with BU+CY, and 38 with TBI+CY.

RESULTS

There were no statistically significant differences in hematopoietic reconstitution, disease free survival (DFS), and transplant- related mortality (TRM) between two groups. The estimated 3- years overall survival (OS) was 56.4% for BU+CY and 31.6% for TBI + CY (P=0.0283). The overall relapse rate was similar between two groups (15.4% vs 34.2%; P=0.1538). However, the accumulative probability of relapse at 1-year was significantly lower in BU+CY than that in TBI+CY group (2.56% vs 26.67%; P=0.0116). The incidence of grade II-IV graft-versus-host disease (GVHD) was similar between two regimens (20.5% in BU+CY group and 18.4% in TBI+CY group; P=0.8168). The incidence of chronic GVHD (cGVHD) was higher in the TBI+CY group than that of BU+CY group (84.6% vs 41.1%; P=0.0007). The extensive GVHD obtained the similar outcome (30.8% vs 10.5%; P=0.0416).

CONCLUSION

Patients using BU+CY as conditioning regimen before transplant could obtain a better 3 year OS and lower short-term relapse rate. The TBI+CY conditioning regimen could significantly increase the incidence of cGVHD without increasing the acute GVHD. BU+CY conditioning regimen could be used for HSCT, but the attention should be paid to prevent the related hemorrhagic cystitis.

Authors+Show Affiliations

Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

chi

PubMed ID

24985173

Citation

Shao, Qun, et al. "[Effect of BU and CY Versus TBI and CY as Conditioning Regimens On the Efficacy of Haploidentical Stem Cell Transplantation in Patients With Hematologic Malignancy]." Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi, vol. 35, no. 6, 2014, pp. 505-10.
Shao Q, Han D, Liu D, et al. [Effect of BU and CY versus TBI and CY as conditioning regimens on the efficacy of haploidentical stem cell transplantation in patients with hematologic malignancy]. Zhonghua Xue Ye Xue Za Zhi. 2014;35(6):505-10.
Shao, Q., Han, D., Liu, D., Zheng, X., Dong, L., Wang, Z., Ding, L., Yan, H., Wang, H., & Duan, L. (2014). [Effect of BU and CY versus TBI and CY as conditioning regimens on the efficacy of haploidentical stem cell transplantation in patients with hematologic malignancy]. Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi, 35(6), 505-10. https://doi.org/10.3760/cma.j.issn.0253-2727.2014.06.007
Shao Q, et al. [Effect of BU and CY Versus TBI and CY as Conditioning Regimens On the Efficacy of Haploidentical Stem Cell Transplantation in Patients With Hematologic Malignancy]. Zhonghua Xue Ye Xue Za Zhi. 2014;35(6):505-10. PubMed PMID: 24985173.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effect of BU and CY versus TBI and CY as conditioning regimens on the efficacy of haploidentical stem cell transplantation in patients with hematologic malignancy]. AU - Shao,Qun, AU - Han,Dongmei, AU - Liu,Danbo, AU - Zheng,Xiaoli, AU - Dong,Lei, AU - Wang,Zhidong, AU - Ding,Li, AU - Yan,Hongmin, AU - Wang,Hengxiang, AU - Duan,Lianning, PY - 2014/7/3/entrez PY - 2014/7/6/pubmed PY - 2015/1/6/medline SP - 505 EP - 10 JF - Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi JO - Zhonghua Xue Ye Xue Za Zhi VL - 35 IS - 6 N2 - OBJECTIVE: To investigate the therapeutic effects of the conditioning regimen with busulfan plus cyclophosphamide (BU+CY) or total body irradiation plus cyclophosphamide (TBI+CY) on haploidentical stem cell transplantation (HSCT) in hematologic malignancy. METHODS: The clinical outcomes of 77 HSCT recipients with hematologic malignancy from January 2001 to December 2010, including 21 AML, 33 ALL, 19 CML and 4 MDS were retrospectively evaluated. Among them, 65 patients obtained complete remission (CR) and 12 non-remission (NR) before transplantation; 39 patients received conditioning regimen with BU+CY, and 38 with TBI+CY. RESULTS: There were no statistically significant differences in hematopoietic reconstitution, disease free survival (DFS), and transplant- related mortality (TRM) between two groups. The estimated 3- years overall survival (OS) was 56.4% for BU+CY and 31.6% for TBI + CY (P=0.0283). The overall relapse rate was similar between two groups (15.4% vs 34.2%; P=0.1538). However, the accumulative probability of relapse at 1-year was significantly lower in BU+CY than that in TBI+CY group (2.56% vs 26.67%; P=0.0116). The incidence of grade II-IV graft-versus-host disease (GVHD) was similar between two regimens (20.5% in BU+CY group and 18.4% in TBI+CY group; P=0.8168). The incidence of chronic GVHD (cGVHD) was higher in the TBI+CY group than that of BU+CY group (84.6% vs 41.1%; P=0.0007). The extensive GVHD obtained the similar outcome (30.8% vs 10.5%; P=0.0416). CONCLUSION: Patients using BU+CY as conditioning regimen before transplant could obtain a better 3 year OS and lower short-term relapse rate. The TBI+CY conditioning regimen could significantly increase the incidence of cGVHD without increasing the acute GVHD. BU+CY conditioning regimen could be used for HSCT, but the attention should be paid to prevent the related hemorrhagic cystitis. SN - 0253-2727 UR - https://www.unboundmedicine.com/medline/citation/24985173/[Effect_of_BU_and_CY_versus_TBI_and_CY_as_conditioning_regimens_on_the_efficacy_of_haploidentical_stem_cell_transplantation_in_patients_with_hematologic_malignancy]_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -