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Reduced-Intensity Conditioning with Busulfan and Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Lymphoblastic Leukemia
- Reduced-Intensity Conditioning with Busulfan and Fludarabine for Allogeneic Hematopoietic Stem Cell Transplantation in Acute Lymphoblastic Leukemia
- Mun, Yeung-Chul; Lee, Won-Sik; Lee, Seok; Yang, Deok-Hwan; 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
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- YONSEI MEDICAL JOURNAL
- YONSEI MEDICAL JOURNAL vol. 61, no. 6, pp. 452 - 459
- Fludarabine; busulfan; lymphoblastic leukemia; stem cell transplantation; transplantation conditioning
- YONSEI UNIV COLL MEDICINE
- SCIE; SCOPUS; KCI
- Document Type
- 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/m(2)/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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