Reduced-Intensity Conditioning with Busulfan and Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Lymphoblastic Leukemia
- Author(s)
- Seung Shin Lee; Sung Hoon Jung; Young Rok Do; Dae Sik Kim; Ji Hyun Lee; Han Seung Park; Joon Ho Moon; Jun Ho Yi; Yong Park; Youngil Koh; Ho Young Yhim; Yunsuk Choi; Yeung Chul Mun; Won Sik Lee; Seok Lee; Deok Hwan Yang
- Keimyung Author(s)
- Do, Young Rok
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Yonsei Medical Journal
- Issued Date
- 2020
- Volume
- 61
- Issue
- 6
- Keyword
- Fludarabine; busulfan; lymphoblastic leukemia; stem cell transplantation; transplantation conditioning
- 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.
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