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

Content Provider	Europe PMC
Author	Lee, Seung-Shin Jung, Sung-Hoon Do, Young Rok Kim, Dae Sik Lee, Ji Hyun Park, Han-Seung Moon, Joon Ho Yi, Jun Ho Park, Yong Koh, Youngil Yhim, Ho-Young Choi, Yunsuk Mun, Yeung-Chul Lee, Won-Sik Lee, Seok Yang, Deok-Hwan
Copyright Year	2020
Abstract	PurposeAllogeneic 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 MethodsRecords 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.ResultsThe 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.ConclusionRIC with busulfan and fludarabine is an effective and safe conditioning regimen for adult ALL patients unfit for myeloablation.
ISSN	05135796
Volume Number	61
PubMed Central reference number	PMC7256005
Issue Number	6
PubMed reference number	32469169
Journal	Yonsei Medical Journal [Yonsei Med. J]
e-ISSN	19762437
DOI	10.3349/ymj.2020.61.6.452
Language	English
Publisher	Yonsei University College of Medicine
Publisher Date	2020-06-01
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. © Copyright: Yonsei University College of Medicine 2020
Subject Keyword	Fludarabine busulfan lymphoblastic leukemia stem cell transplantation transplantation conditioning
Content Type	Text
Resource Type	Article
Subject	Medicine