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Reduced-Intensity Conditioning with Busulfan and Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Lymphoblastic Leukemia.
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- Author(s): Lee SS;Lee SS; Jung SH; Jung SH; Do YR; Do YR; Kim DS; Kim DS; Lee JH; Lee JH; Park HS; Park HS; Moon JH; Moon JH; Yi JH; Yi JH; Park Y; Park Y; Koh Y; Koh Y; Yhim HY; Yhim HY; Choi Y; Choi Y; Mun YC; Mun YC; Lee WS; Lee WS; Lee S; Lee S; Yang DH; Yang DH
- Source:
Yonsei medical journal [Yonsei Med J] 2020 Jun; Vol. 61 (6), pp. 452-459.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Corporate Authors:
- Source: Publisher: Yonsei University Country of Publication: Korea (South) NLM ID: 0414003 Publication Model: Print Cited Medium: Internet ISSN: 1976-2437 (Electronic) Linking ISSN: 05135796 NLM ISO Abbreviation: Yonsei Med J Subsets: MEDLINE
- Publication Information: Original Publication: Seoul : Yonsei University
- Subject Terms: Hematopoietic Stem Cell Transplantation*/adverse effects ; Transplantation Conditioning*; Busulfan/*therapeutic use ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*therapy ; Vidarabine/*analogs & derivatives; Acute Disease ; Adolescent ; Adult ; Aged ; Female ; Graft vs Host Disease/etiology ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Recurrence ; Transplantation, Homologous ; Vidarabine/therapeutic use ; Young Adult
- Abstract: Purpose: Allogeneic hematopoietic stem cell transplantation (HSCT) with optimal conditioning has helped better long-term survival in acute lymphoblastic leukemia (ALL). This study investigated the efficacy and safety of reduced-intensity conditioning (RIC) with busulfan and fludarabine in adult ALL patients unfit for myeloablation.
Materials and Methods: Records of 78 patients who underwent HSCT with RIC consisting of 3.2 mg/kg/day of busulfan for 2 or 3 days and 30 mg/m²/day of fludarabine for 5 or 6 days were analyzed.
Results: The median age at diagnosis was 49 years. Over a median follow-up of 22 months, 2-year estimates of relapse-free survival (RFS) and overall survival were 57.4% and 68.7%, respectively. Multivariate analysis showed a trend of improved RFS in patients with chronic graft-versus-host disease (GVHD) (hazard ratio, 0.53; 95% confidence interval, 0.26-1.08; p =0.080). The cumulative incidences of relapse and non-relapse mortality were 42.9% and 19.6%, respectively and one case of central nervous system relapse was noted. No hepatic veno-occlusive disease was reported. Grade II-IV acute GVHD and any grade chronic GVHD occurred in 21.1% and 41.7%, respectively.
Conclusion: RIC with busulfan and fludarabine is an effective and safe conditioning regimen for adult ALL patients unfit for myeloablation.
Competing Interests: The authors have no potential conflicts of interest to disclose.
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Biol Blood Marrow Transplant. 2011 Oct;17(10):1505-11. (PMID: 21385623) - Contributed Indexing: Keywords: Fludarabine; busulfan; lymphoblastic leukemia; stem cell transplantation; transplantation conditioning
- Accession Number: FA2DM6879K (Vidarabine)
G1LN9045DK (Busulfan)
P2K93U8740 (fludarabine) - Publication Date: Date Created: 20200530 Date Completed: 20200727 Latest Revision: 20200727
- Publication Date: 20231215
- Accession Number: PMC7256005
- Accession Number: 10.3349/ymj.2020.61.6.452
- Accession Number: 32469169
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