Tags

Type your tag names separated by a space and hit enter

A modified busulfan and cyclophosphamide preparative regimen for allogeneic transplantation in myeloid malignancies.
Int J Clin Pharm. 2015 Feb; 37(1):44-52.IJ

Abstract

BACKGROUND

Busulfan/cyclophosphamide (Bu/Cy) is commonly used as a standard conditioning regimen without total body irradiation for patients with hematological myeloid malignancies undergoing hematopoietic stem cell transplantation (HSCT).

OBJECTIVE

To develop a new myeloablative conditioning regimen incorporating fludarabine (Flu) and cytarabine (Ara-c).

SETTING

A tertiary blood disease hospital in Tianjin, China.

METHODS

A Bu/Cy preparative regimen was used, modified by Flu 90 mg/m(2) and Ara-c 6 g/m(2) in 57 unselected patients (median age 37 years) with hematological myeloid malignancies. The patients were to receive allogeneic hematopoietic stem cell transplantation (allo-HSCT). Thirteen patients had high-risk leukemia, fifty patients had HLA matched sibling donors while seven patients had HLA mismatched sibling donors. Cy was given 50 mg/kg/day for 2 days while Bu was given 3.2 mg/kg/day intravenously for 3 days.

MAIN OUTCOME MEASURE

Post-transplant donor chimerism, relapse tendency and minimal residual disease.

RESULTS

Extramedullar toxicity was relatively limited; the incidence of treatment-related mortality (TRM) within 100 days was 3.5 %. The incidence of grade II-IV, grade III-IV acute graft versus host disease (GVHD) and chronic GVHD of the evaluable patients were 21.1, 8.8 and 36.4 %, respectively. With a median follow up of 59 (13-96.5) months, TRM and relapse rate (RR) at eight years were 24.1 ± 5.8 and 14.7 ± 4.8 %, respectively. Disease free survival at eight years was 67.9 ± 6.2 % for the entire group, 60.0 ± 8.9 % for patients with AML, 77.3 ± 8.9 % for patients with CML, 70.0 ± 6.5 and 42.9 ± 18.7 % or matched sibling and mismatched sibling HSCT respectively.

CONCLUSION

The new regimen was associated with a low relapse rate, low incidence and severity of graft versus host disease and satisfactory survival for patients with myeloid malignancies.

Authors+Show Affiliations

Center of Hematopoietic Stem Cell Transplantation, Blood Disease Hospital, Institute of Hematology, Peking Union College, Chinese Academy of Medical Sciences, Tianjin, China.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25432692

Citation

Cai, Xiaojin, et al. "A Modified Busulfan and Cyclophosphamide Preparative Regimen for Allogeneic Transplantation in Myeloid Malignancies." International Journal of Clinical Pharmacy, vol. 37, no. 1, 2015, pp. 44-52.
Cai X, Wei J, He Y, et al. A modified busulfan and cyclophosphamide preparative regimen for allogeneic transplantation in myeloid malignancies. Int J Clin Pharm. 2015;37(1):44-52.
Cai, X., Wei, J., He, Y., Yang, D., Jiang, E., Huang, Y., Han, M., & Feng, S. (2015). A modified busulfan and cyclophosphamide preparative regimen for allogeneic transplantation in myeloid malignancies. International Journal of Clinical Pharmacy, 37(1), 44-52. https://doi.org/10.1007/s11096-014-0036-5
Cai X, et al. A Modified Busulfan and Cyclophosphamide Preparative Regimen for Allogeneic Transplantation in Myeloid Malignancies. Int J Clin Pharm. 2015;37(1):44-52. PubMed PMID: 25432692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A modified busulfan and cyclophosphamide preparative regimen for allogeneic transplantation in myeloid malignancies. AU - Cai,Xiaojin, AU - Wei,Jialing, AU - He,Yi, AU - Yang,Dongling, AU - Jiang,Erlie, AU - Huang,Yong, AU - Han,Mingzhe, AU - Feng,Sizhou, Y1 - 2014/11/29/ PY - 2014/07/01/received PY - 2014/11/02/accepted PY - 2014/11/30/entrez PY - 2014/11/30/pubmed PY - 2015/10/27/medline SP - 44 EP - 52 JF - International journal of clinical pharmacy JO - Int J Clin Pharm VL - 37 IS - 1 N2 - BACKGROUND: Busulfan/cyclophosphamide (Bu/Cy) is commonly used as a standard conditioning regimen without total body irradiation for patients with hematological myeloid malignancies undergoing hematopoietic stem cell transplantation (HSCT). OBJECTIVE: To develop a new myeloablative conditioning regimen incorporating fludarabine (Flu) and cytarabine (Ara-c). SETTING: A tertiary blood disease hospital in Tianjin, China. METHODS: A Bu/Cy preparative regimen was used, modified by Flu 90 mg/m(2) and Ara-c 6 g/m(2) in 57 unselected patients (median age 37 years) with hematological myeloid malignancies. The patients were to receive allogeneic hematopoietic stem cell transplantation (allo-HSCT). Thirteen patients had high-risk leukemia, fifty patients had HLA matched sibling donors while seven patients had HLA mismatched sibling donors. Cy was given 50 mg/kg/day for 2 days while Bu was given 3.2 mg/kg/day intravenously for 3 days. MAIN OUTCOME MEASURE: Post-transplant donor chimerism, relapse tendency and minimal residual disease. RESULTS: Extramedullar toxicity was relatively limited; the incidence of treatment-related mortality (TRM) within 100 days was 3.5 %. The incidence of grade II-IV, grade III-IV acute graft versus host disease (GVHD) and chronic GVHD of the evaluable patients were 21.1, 8.8 and 36.4 %, respectively. With a median follow up of 59 (13-96.5) months, TRM and relapse rate (RR) at eight years were 24.1 ± 5.8 and 14.7 ± 4.8 %, respectively. Disease free survival at eight years was 67.9 ± 6.2 % for the entire group, 60.0 ± 8.9 % for patients with AML, 77.3 ± 8.9 % for patients with CML, 70.0 ± 6.5 and 42.9 ± 18.7 % or matched sibling and mismatched sibling HSCT respectively. CONCLUSION: The new regimen was associated with a low relapse rate, low incidence and severity of graft versus host disease and satisfactory survival for patients with myeloid malignancies. SN - 2210-7711 UR - https://www.unboundmedicine.com/medline/citation/25432692/A_modified_busulfan_and_cyclophosphamide_preparative_regimen_for_allogeneic_transplantation_in_myeloid_malignancies_ L2 - https://dx.doi.org/10.1007/s11096-014-0036-5 DB - PRIME DP - Unbound Medicine ER -