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Comparison of Different Conditioning Regimens of Haploidentical Hematopoietic Stem Cell Transplant in Patients With Acute Myeloid Leukemia.
Exp Clin Transplant. 2018 12; 16(6):736-744.EC

Abstract

OBJECTIVES

We evaluated the safety and efficacy of 2 conditioning regimens (busulfan/fludarabine vs modified busulfan/cyclophosphamide) in patients with acute myeloid leukemia undergoing haploidentical hematopoietic stem cell transplant.

MATERAILS AND METHODS

Twenty patients with primary acute myeloid leukemia had been randomized into busulfan/fludarabine and modified busulfan/cyclophosphamide groups. We retrospectively compared hematopoietic engraftment, regimen-related toxicity, graft-versus-host disease, transplant-related mortality, leukemia-free survival, and overall survival between the groups.

RESULTS

All patients achieved engraftment with 100% donor chimerism. The median times for the neutrophil and platelet engraftment in the busulfan/fludarabine and modified busulfan/cyclophosphamide groups were 14.1 versus 14.3 days and 12.7 versus 12.2 days, respectively. Significantly lower incidences of pretreatment toxicity, blood transfusion, and virus activation were observed in the busulfan/fludarabine group. Acute grade 1 graft-versus-host-disease developed in all patients, which was successfully controlled with methylprednisolone. There were no significant differences in engraftment, graft-versus-host disease, leukemia-free survival, and overall survival between groups. Both of these conditioning regimens achieved stable engraftment. Regimen-related toxicity in the busulfan/fludarabine group was well tolerated compared with that in the modified busulfan/cyclophosphamide group, without an increase in relapse rate.

CONCLUSIONS

Our results demonstrated that myeloablative busulfan/fludarabine might be a highly effective and low-toxicity alternative for patients with acute myeloid leukemia.

Authors+Show Affiliations

From the Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, 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 available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29790457

Citation

Jiang, Yujie, et al. "Comparison of Different Conditioning Regimens of Haploidentical Hematopoietic Stem Cell Transplant in Patients With Acute Myeloid Leukemia." Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation, vol. 16, no. 6, 2018, pp. 736-744.
Jiang Y, Fang X, Sui X, et al. Comparison of Different Conditioning Regimens of Haploidentical Hematopoietic Stem Cell Transplant in Patients With Acute Myeloid Leukemia. Exp Clin Transplant. 2018;16(6):736-744.
Jiang, Y., Fang, X., Sui, X., Liu, X., Li, Y., Wang, X., Xu, H., Zhang, L., & Wang, X. (2018). Comparison of Different Conditioning Regimens of Haploidentical Hematopoietic Stem Cell Transplant in Patients With Acute Myeloid Leukemia. Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation, 16(6), 736-744. https://doi.org/10.6002/ect.2017.0100
Jiang Y, et al. Comparison of Different Conditioning Regimens of Haploidentical Hematopoietic Stem Cell Transplant in Patients With Acute Myeloid Leukemia. Exp Clin Transplant. 2018;16(6):736-744. PubMed PMID: 29790457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Different Conditioning Regimens of Haploidentical Hematopoietic Stem Cell Transplant in Patients With Acute Myeloid Leukemia. AU - Jiang,Yujie, AU - Fang,Xiaosheng, AU - Sui,Xiaohui, AU - Liu,Xin, AU - Li,Ying, AU - Wang,Xianghua, AU - Xu,Hongzhi, AU - Zhang,Lingyan, AU - Wang,Xin, Y1 - 2018/05/23/ PY - 2018/5/24/pubmed PY - 2019/4/10/medline PY - 2018/5/24/entrez SP - 736 EP - 744 JF - Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation JO - Exp Clin Transplant VL - 16 IS - 6 N2 - OBJECTIVES: We evaluated the safety and efficacy of 2 conditioning regimens (busulfan/fludarabine vs modified busulfan/cyclophosphamide) in patients with acute myeloid leukemia undergoing haploidentical hematopoietic stem cell transplant. MATERAILS AND METHODS: Twenty patients with primary acute myeloid leukemia had been randomized into busulfan/fludarabine and modified busulfan/cyclophosphamide groups. We retrospectively compared hematopoietic engraftment, regimen-related toxicity, graft-versus-host disease, transplant-related mortality, leukemia-free survival, and overall survival between the groups. RESULTS: All patients achieved engraftment with 100% donor chimerism. The median times for the neutrophil and platelet engraftment in the busulfan/fludarabine and modified busulfan/cyclophosphamide groups were 14.1 versus 14.3 days and 12.7 versus 12.2 days, respectively. Significantly lower incidences of pretreatment toxicity, blood transfusion, and virus activation were observed in the busulfan/fludarabine group. Acute grade 1 graft-versus-host-disease developed in all patients, which was successfully controlled with methylprednisolone. There were no significant differences in engraftment, graft-versus-host disease, leukemia-free survival, and overall survival between groups. Both of these conditioning regimens achieved stable engraftment. Regimen-related toxicity in the busulfan/fludarabine group was well tolerated compared with that in the modified busulfan/cyclophosphamide group, without an increase in relapse rate. CONCLUSIONS: Our results demonstrated that myeloablative busulfan/fludarabine might be a highly effective and low-toxicity alternative for patients with acute myeloid leukemia. SN - 2146-8427 UR - https://www.unboundmedicine.com/medline/citation/29790457/Comparison_of_Different_Conditioning_Regimens_of_Haploidentical_Hematopoietic_Stem_Cell_Transplant_in_Patients_With_Acute_Myeloid_Leukemia_ L2 - http://www.ectrx.org/forms/ectrxcontentshow.php?year=2018&volume=16&issue=6&supplement=0&makale_no=0&spage_number=736&content_type=FULL TEXT DB - PRIME DP - Unbound Medicine ER -