Reduced-Intensity Conditioning with Busulfan and Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Lymphoblastic Leukemia.

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

Original Publication: Seoul : Yonsei University

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

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.
(© Copyright: Yonsei University College of Medicine 2020.)

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Keywords: Fludarabine; busulfan; lymphoblastic leukemia; stem cell transplantation; transplantation conditioning

FA2DM6879K (Vidarabine)
G1LN9045DK (Busulfan)
P2K93U8740 (fludarabine)

Date Created: 20200530 Date Completed: 20200727 Latest Revision: 20200727

20231215

PMC7256005

10.3349/ymj.2020.61.6.452

32469169