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A new intensive conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with refractory or relapsed acute myeloid leukemia.
Medicine (Baltimore). 2018 Apr; 97(17):e0228.M

Abstract

To explore the efficacy, and safety of the intensive conditioning regimen consisting of cladribine, cytarabine (Ara-C), and granulocyte colony-stimulating factor (G-CSF) plus modified busulfan (Bu) combined with cytoxan (Cy) (BuCy), prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with refractory, or relapsed acute myeloid leukemia (R/R AML).Thirty-Six R/R AML patients scheduled to receive allo-HSCT were consecutively, enrolled in this prospective study, and treated using intensive conditioning regimen consisting of CLAG plus modified BuCy. Median follow-up duration was 11.25 (range 0.5 - 21.0) months and the last follow up date was August 15, 2017.All patients (100%) achieved white blood cell (WBC) recovery within a median time of 16.00 (13.25 - 18.00) days, and 34 of them (94%) attained platelet (PLT) recovery within a median time of 13.50 (9.25 - 19.75) days. Incidence of acute graft-versus-host disease (aGVHD) was 50.00%, with median time of 71.50 (41.00 - 401.25) days. Three patients developed Grade I; nine, Grade II; 5, Grade III; and 1, Grade IV aGVHD. The incidence of chronic GVHD (cGVHD) was 44.40%, with median time of 255.00 (120.00 - 390.00) days. Four patients developed limited cGVHD, and 12, extensive cGVHD. One-year accumulating leukemia free survival (LFS), and overall survival (OS) rates between 52.9 ± 8.8% to 69.4 ± 7.7%, respectively. Eighteen (50%) patients were infected with cytomegalovirus; 2 (5.6%), with Epstein-Barr virus (EBV), 7 (19.4%), with hemorrhagic cystitis; 13 (36.1%), with bacteria; and 8 (22.2%), with fungus.Intensive conditioning regimen of CLAG plus modified BuCy for allo-HSCT may be effective and well-tolerated in R/R AML patients.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

29702970

Citation

Wang, Jingbo, et al. "A New Intensive Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Refractory or Relapsed Acute Myeloid Leukemia." Medicine, vol. 97, no. 17, 2018, pp. e0228.
Wang J, Zhao J, Fei X, et al. A new intensive conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with refractory or relapsed acute myeloid leukemia. Medicine (Baltimore). 2018;97(17):e0228.
Wang, J., Zhao, J., Fei, X., Yin, Y., Cheng, H., Zhang, W., Gu, J., Yang, F., Yang, Y., Xue, S., Tian, Z., He, J., Zhang, S., & Wang, X. (2018). A new intensive conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with refractory or relapsed acute myeloid leukemia. Medicine, 97(17), e0228. https://doi.org/10.1097/MD.0000000000010228
Wang J, et al. A New Intensive Conditioning Regimen for Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Refractory or Relapsed Acute Myeloid Leukemia. Medicine (Baltimore). 2018;97(17):e0228. PubMed PMID: 29702970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A new intensive conditioning regimen for allogeneic hematopoietic stem cell transplantation in patients with refractory or relapsed acute myeloid leukemia. AU - Wang,Jingbo, AU - Zhao,Jie, AU - Fei,Xinhong, AU - Yin,Yuming, AU - Cheng,Haoyu, AU - Zhang,Weijie, AU - Gu,Jiangying, AU - Yang,Fan, AU - Yang,Yixin, AU - Xue,Song, AU - Tian,Zhengqin, AU - He,Junbao, AU - Zhang,Shuqin, AU - Wang,Xiaocan, PY - 2018/4/29/entrez PY - 2018/4/29/pubmed PY - 2018/5/15/medline SP - e0228 EP - e0228 JF - Medicine JO - Medicine (Baltimore) VL - 97 IS - 17 N2 - To explore the efficacy, and safety of the intensive conditioning regimen consisting of cladribine, cytarabine (Ara-C), and granulocyte colony-stimulating factor (G-CSF) plus modified busulfan (Bu) combined with cytoxan (Cy) (BuCy), prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with refractory, or relapsed acute myeloid leukemia (R/R AML).Thirty-Six R/R AML patients scheduled to receive allo-HSCT were consecutively, enrolled in this prospective study, and treated using intensive conditioning regimen consisting of CLAG plus modified BuCy. Median follow-up duration was 11.25 (range 0.5 - 21.0) months and the last follow up date was August 15, 2017.All patients (100%) achieved white blood cell (WBC) recovery within a median time of 16.00 (13.25 - 18.00) days, and 34 of them (94%) attained platelet (PLT) recovery within a median time of 13.50 (9.25 - 19.75) days. Incidence of acute graft-versus-host disease (aGVHD) was 50.00%, with median time of 71.50 (41.00 - 401.25) days. Three patients developed Grade I; nine, Grade II; 5, Grade III; and 1, Grade IV aGVHD. The incidence of chronic GVHD (cGVHD) was 44.40%, with median time of 255.00 (120.00 - 390.00) days. Four patients developed limited cGVHD, and 12, extensive cGVHD. One-year accumulating leukemia free survival (LFS), and overall survival (OS) rates between 52.9 ± 8.8% to 69.4 ± 7.7%, respectively. Eighteen (50%) patients were infected with cytomegalovirus; 2 (5.6%), with Epstein-Barr virus (EBV), 7 (19.4%), with hemorrhagic cystitis; 13 (36.1%), with bacteria; and 8 (22.2%), with fungus.Intensive conditioning regimen of CLAG plus modified BuCy for allo-HSCT may be effective and well-tolerated in R/R AML patients. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/29702970/A_new_intensive_conditioning_regimen_for_allogeneic_hematopoietic_stem_cell_transplantation_in_patients_with_refractory_or_relapsed_acute_myeloid_leukemia_ DB - PRIME DP - Unbound Medicine ER -