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Busulfan-based regimens and allogeneic bone marrow transplantation in patients with myelodysplastic syndromes
| Content Provider | Scilit |
|---|---|
| Author | Ratanatharathorn, V. Karanes, C. Uberti, J. Lum, Lg Planque, Mm De Schultz, Kr Cronin, S. Dan, Me Mohamed, A. Hussein, M. |
| Copyright Year | 1993 |
| Abstract | Preparative regimens containing busulfan (BU) followed by allogeneic bone marrow transplantation (BMT) were used in 27 consecutive patients with myelodysplastic syndromes (MDS). The median age was 33 years (range, 4 to 54). Ten were female and 17 male. Sixteen patients had primary MDS, 11 other patients had antecedent hematologic diseases or developed MDS after cytotoxic and/or radiation therapy. Six patients had leukemic transformation and received antileukemic therapy before BMT. Pre-BMT cytogenetic studies showed complex chromosomal abnormalities in 13 patients, a simple abnormality in 5 patients, and normal chromosome in 8 patients. Three BU-based preparative regimens were used: 1 patient received BU 4 mg/kg orally (PO) daily for 4 days and cyclophosphamide (CY) 50 mg/kg intravenously (IV) daily for 4 days (BUCY-4); 24 patients received BU 4 mg/kg PO daily for 4 days, cytosine arabinoside (ara-C) 2 g/m2 IV every 12 hours for 4 doses, and CY 60 mg/kg IV daily for 2 days (BAC); and 2 patients with preceding Fanconi anemia received BU 2 mg/kg PO daily for 4 days followed by total lymphoid irradiation of 5 Gy. Seventeen of 27 patients are alive with no evidence of disease. Ten patients have died: 2 from hepatic veno- occlusive disease, 3 from sepsis, 1 from a cerebral bleed, 1 from a massive gastrointestinal (GI) bleed associated with acute graft-versus- host disease, 1 from hemolytic uremic syndrome with adult respiratory distress syndrome, 1 from bronchiolitis obliterans, and the only patient who did not engraft died from acute myeloid leukemia. Regimen- related toxicities (RRT) include GI tract (diarrhea, 14; stomatitis, 11), liver (9), cardiac (1), and skin (5). Patients who received a genotypically matched marrow graft had a significantly better disease- free survival (DFS) than patients who received a nongenotypic marrow graft (P = .02). The Kaplan-Meier analysis projects an overall DFS of 56% +/- 13% and 78% +/- 10% for patients who received a genotypically matched marrow graft. With the exception of a child who did not engraft, there was no relapse of MDS or leukemia. Excellent DFS, acceptable RRT, and the ease of administration are advantages of this regimen. |
| Related Links | https://ashpublications.org/blood/article-pdf/81/8/2194/228209/2194.pdf |
| Ending Page | 2199 |
| Page Count | 6 |
| Starting Page | 2194 |
| DOI | 10.1182/blood.v81.8.2194.bloodjournal8182194 |
| Journal | Blood |
| Issue Number | 8 |
| Volume Number | 81 |
| Language | English |
| Publisher | American Society of Hematology |
| Publisher Date | 1993-04-15 |
| Access Restriction | Open |
| Subject Keyword | Hematology Survival Graft Bone Marrow Child Adult Bmt Dfs Mg/kg Journal: Blood (Vol- 102, Issue- 8) |
| Content Type | Text |
| Resource Type | Article |
