TY - JOUR T1 - Fludarabine and Busulfan versus Fludarabine, Cyclophosphamide, and Rituximab as Reduced-Intensity Conditioning for Allogeneic Transplantation in Follicular Lymphoma. AU - Epperla,Narendranath, AU - Ahn,Kwang Woo, AU - Armand,Philippe, AU - Jaglowski,Samantha, AU - Ahmed,Sairah, AU - Kenkre,Vaishalee P, AU - Savani,Bipin, AU - Jagasia,Madan, AU - Shah,Nirav N, AU - Fenske,Timothy S, AU - Sureda,Anna, AU - Smith,Sonali M, AU - Hamadani,Mehdi, Y1 - 2017/10/13/ PY - 2017/08/23/received PY - 2017/10/05/accepted PY - 2017/10/17/pubmed PY - 2019/3/9/medline PY - 2017/10/17/entrez KW - Allogeneic HCT KW - FCR KW - Flu/Bu KW - Follicular lymphoma KW - Reduced-intensity conditioning SP - 78 EP - 85 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 24 IS - 1 N2 - Large, multicenter studies comparing commonly used reduced-intensity conditioning (RIC) approaches in follicular lymphoma (FL) have not been performed. Using the Center for International Blood and Marrow Transplant Research database, we report the outcomes of the 2 most commonly used RIC approaches, fludarabine and busulfan (Flu/Bu) versus fludarabine, cyclophosphamide, and rituximab (FCR) in FL patients. We evaluated 200 FL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) who received RIC with either Flu/Bu (n = 98) or FCR (n = 102) during 2008 to 2014. All patients received peripheral blood grafts, and graft-versus-host disease (GVHD) prophylaxis was limited to calcineurin inhibitor-based approaches. Median follow-up of survivors in the Flu/Bu and FCR groups was 48 months and 46 months, respectively. On univariate analysis in the Flu/Bu and FCR groups, the 3-year rates of nonrelapse mortality (11% versus 11%, P = .94), relapse/progression (18% versus 15%, P = .54), progression-free survival (PFS) (71% versus 74%, P = .65), and overall survival (OS) (73% versus 81%, P = .18) were not significantly different. On multivariate analysis no difference was seen between the FCR and Flu/Bu cohorts in terms of grades II to IV (relative risk [RR], 1.06; 95% confidence interval [CI], .59 to 1.93; P = .84) or grades III to IV (RR, 1.18; 95% CI, .47 to 2.99; P = .72) acute GVHD, nonrelapse mortality (RR, .83; 95% CI, .38 to 1.82; P = .64), relapse/progression (RR, .99; 95% CI, .49 to 1.98; P = .97), PFS (RR, .92; 95% CI, .55 to 1.54; P = .76), or OS (RR, .70; 95% CI, .40 to 1.23; P = .21) risk. However, RIC with FCR was associated with a significantly reduced chronic GVHD risk (RR, .52; 95% CI, .36 to .77; P = .001). RIC with either Flu/Bu or FCR in patients with FL undergoing allo-HCT provides excellent 3-year OS, with acceptable rates of nonrelapse mortality. FCR-based conditioning was associated with a lower risk of chronic GVHD. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/29032272/Fludarabine_and_Busulfan_versus_Fludarabine_Cyclophosphamide_and_Rituximab_as_Reduced_Intensity_Conditioning_for_Allogeneic_Transplantation_in_Follicular_Lymphoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(17)30770-X DB - PRIME DP - Unbound Medicine ER -