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

Authors
Lee, Seung-ShinJung, Sung-HoonDo, Young RokKim, Dae SikLee, Ji HyunPark, Han-SeungMoon, Joon HoYi, Jun HoPark, YongKoh, YoungilYhim, Ho-YoungChoi, YunsukMun, Yeung-ChulLee, Won-SikLee, SeokYang, Deok-Hwan
Issue Date
6월-2020
Publisher
YONSEI UNIV COLL MEDICINE
Keywords
Fludarabine; busulfan; lymphoblastic leukemia; stem cell transplantation; transplantation conditioning
Citation
YONSEI MEDICAL JOURNAL, v.61, no.6, pp.452 - 459
Indexed
SCIE
SCOPUS
KCI
Journal Title
YONSEI MEDICAL JOURNAL
Volume
61
Number
6
Start Page
452
End Page
459
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/55502
DOI
10.3349/ymj.2020.61.6.452
ISSN
0513-5796
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/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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