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[Clinical outcome of allogeneic hematopoietic stem cell transplantation with FLAG sequential busulfan/cyclophosphamide conditioning regimen for refractory/relapsed acute myeloid leukemia].
Zhonghua Nei Ke Za Zhi. 2018 Aug 01; 57(8):576-581.ZN

Abstract

Objective:

To investigate the therapeutic effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FLAG sequential busulfan/cyclophosphamide(Bu/Cy) conditioning regimen for refractory/relapsed acute myeloid leukemia.

Methods:

From February 2012 to June 2017, 21 patients with refractory/relapsed acute myeloid leukemia underwent allo-HSCT with FLAG sequential Bu/Cy conditioning regimen. Transplantation-related complications and clinical outcome were retrospectively analyzed.

Results:

After conditioning, no hepatic veno-occlusive disease (VOD) and grade Ⅲ hemorrhagic cystitis occurred. 76.2% (16/21) patients had fever with 4 septicemia. One patient died of septic shock before engraftment. Twenty patients achieved neutrophil engraftment with a median time of 13 days (range, 10 to 21 days). Seventeen patients achieved platelet engraftment with a median time of 18 days (range, 9 to 25 days). The cumulative incidence of acute graft-versus-host disease (aGVHD) was 39.5%, and 3 patients developed grade Ⅲ-Ⅳ aGVHD. Of 19 patients who survived more than 100 days after transplantation, 4 had local chronic graft-versus-host disease (cGVHD). Of 21 patients, the median survival time was 15 months (range, 0.5 to 67 months) post-transplantation. Transplantation-related mortality rate was 28.7%. Leukemia relapse occurred in 4 patients with a median time of 4 months (range, 3 to 8 months) after transplantation. The cumulative relapse rate at 1 year was 21.4%. The 1-year and 3-year overall survival (OS) rates were 60.7% and 54.9% respectively. Log-rank analysis revealed that bone marrow blasts ≥ 20% or extramedullary leukemia before transplantation, poor platelet engraftment and grade Ⅲ-Ⅳ aGVHD were significantly related to shortened OS (P<0.05).

Conclusions:

Allo-HSCT with FLAG sequential Bu/Cy conditioning regimen in patients with refractory/relapsed myeloid leukemia has acceptable transplantation-related risk and relapse rate. The 1-year and 3-year OS rates are comparable with those in remission patients.

Authors+Show Affiliations

Department of Hematology, Peking University First Hospital, Beijing 100034, 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 availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

chi

PubMed ID

30060329

Citation

Liu, W, et al. "[Clinical Outcome of Allogeneic Hematopoietic Stem Cell Transplantation With FLAG Sequential Busulfan/cyclophosphamide Conditioning Regimen for Refractory/relapsed Acute Myeloid Leukemia]." Zhonghua Nei Ke Za Zhi, vol. 57, no. 8, 2018, pp. 576-581.
Liu W, Li Y, Qiu ZX, et al. [Clinical outcome of allogeneic hematopoietic stem cell transplantation with FLAG sequential busulfan/cyclophosphamide conditioning regimen for refractory/relapsed acute myeloid leukemia]. Zhonghua Nei Ke Za Zhi. 2018;57(8):576-581.
Liu, W., Li, Y., Qiu, Z. X., Yin, Y., Sun, Y. H., Xu, W. L., Wang, Q., Liang, Z. Y., Dong, Y. J., Wang, L. H., Cen, Q. N., Wang, M. J., Wang, W. S., Ou, J. P., & Ren, H. Y. (2018). [Clinical outcome of allogeneic hematopoietic stem cell transplantation with FLAG sequential busulfan/cyclophosphamide conditioning regimen for refractory/relapsed acute myeloid leukemia]. Zhonghua Nei Ke Za Zhi, 57(8), 576-581. https://doi.org/10.3760/cma.j.issn.0578-1426.2018.08.008
Liu W, et al. [Clinical Outcome of Allogeneic Hematopoietic Stem Cell Transplantation With FLAG Sequential Busulfan/cyclophosphamide Conditioning Regimen for Refractory/relapsed Acute Myeloid Leukemia]. Zhonghua Nei Ke Za Zhi. 2018 Aug 1;57(8):576-581. PubMed PMID: 30060329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical outcome of allogeneic hematopoietic stem cell transplantation with FLAG sequential busulfan/cyclophosphamide conditioning regimen for refractory/relapsed acute myeloid leukemia]. AU - Liu,W, AU - Li,Y, AU - Qiu,Z X, AU - Yin,Y, AU - Sun,Y H, AU - Xu,W L, AU - Wang,Q, AU - Liang,Z Y, AU - Dong,Y J, AU - Wang,L H, AU - Cen,Q N, AU - Wang,M J, AU - Wang,W S, AU - Ou,J P, AU - Ren,H Y, PY - 2018/7/31/entrez PY - 2018/8/1/pubmed PY - 2018/9/1/medline KW - Allogeneic hematopoietic stem cell transplantation KW - FLAG regimen KW - Refractory/relapsed acute myeloid leukemia KW - Transplantation conditioning SP - 576 EP - 581 JF - Zhonghua nei ke za zhi JO - Zhonghua Nei Ke Za Zhi VL - 57 IS - 8 N2 - Objective: To investigate the therapeutic effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FLAG sequential busulfan/cyclophosphamide(Bu/Cy) conditioning regimen for refractory/relapsed acute myeloid leukemia. Methods: From February 2012 to June 2017, 21 patients with refractory/relapsed acute myeloid leukemia underwent allo-HSCT with FLAG sequential Bu/Cy conditioning regimen. Transplantation-related complications and clinical outcome were retrospectively analyzed. Results: After conditioning, no hepatic veno-occlusive disease (VOD) and grade Ⅲ hemorrhagic cystitis occurred. 76.2% (16/21) patients had fever with 4 septicemia. One patient died of septic shock before engraftment. Twenty patients achieved neutrophil engraftment with a median time of 13 days (range, 10 to 21 days). Seventeen patients achieved platelet engraftment with a median time of 18 days (range, 9 to 25 days). The cumulative incidence of acute graft-versus-host disease (aGVHD) was 39.5%, and 3 patients developed grade Ⅲ-Ⅳ aGVHD. Of 19 patients who survived more than 100 days after transplantation, 4 had local chronic graft-versus-host disease (cGVHD). Of 21 patients, the median survival time was 15 months (range, 0.5 to 67 months) post-transplantation. Transplantation-related mortality rate was 28.7%. Leukemia relapse occurred in 4 patients with a median time of 4 months (range, 3 to 8 months) after transplantation. The cumulative relapse rate at 1 year was 21.4%. The 1-year and 3-year overall survival (OS) rates were 60.7% and 54.9% respectively. Log-rank analysis revealed that bone marrow blasts ≥ 20% or extramedullary leukemia before transplantation, poor platelet engraftment and grade Ⅲ-Ⅳ aGVHD were significantly related to shortened OS (P<0.05). Conclusions: Allo-HSCT with FLAG sequential Bu/Cy conditioning regimen in patients with refractory/relapsed myeloid leukemia has acceptable transplantation-related risk and relapse rate. The 1-year and 3-year OS rates are comparable with those in remission patients. SN - 0578-1426 UR - https://www.unboundmedicine.com/medline/citation/30060329/[Clinical_outcome_of_allogeneic_hematopoietic_stem_cell_transplantation_with_FLAG_sequential_busulfan/cyclophosphamide_conditioning_regimen_for_refractory/relapsed_acute_myeloid_leukemia]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0578-1426&amp;year=2018&amp;vol=57&amp;issue=8&amp;fpage=576 DB - PRIME DP - Unbound Medicine ER -