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KMID : 0366220100450020102
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Korean Journal of Hematology
2010 Volume.45 No. 2 p.102 ~ p.108
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Fludarabine-based myeloablative regimen as pretransplant conditioning therapy in adult acute leukemia/myelodysplastic syndrome: comparison with oral or intravenous busulfan with cyclophosphamide
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Lee Ji-Hyun
Choi Ji-min
Kwon Kyung-A
Lee Suee
Oh Sung-Yong
Kwon Hyuk-Chan
Kim Hyo-Jin
Han Jin-Young
Kim Sung-Hyun
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Abstract
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Background: A combination of busulfan (Bu) and cyclophosphamide (Cy) has been used as a standard myeloablative regimen for allogeneic hematopoietic stem cell transplantation (HSCT). Recent studies postulate that fludarabine (Flu) is a less toxic substitute for Cy.
Methods: Forty-two patients who were diagnosed with acute leukemia or myelodysplastic syndrome and received BuFlu (n=17) or BuCy (n=25) from August, 1999 to July, 2009 at Dong-A University Medical Center were retrospectively analyzed.
Results: The median follow-up duration was 39.75 months. The BuFlu group showed a lower incidence of mucositis (P=0.005), but there was no significant intergroup difference in the time of engraftment, nausea/vomiting, acute/chronic graft-versus-host disease, hepatic veno-occlusive disease, or hemorrhagic cystitis. Moreover, the 2 groups showed no significant difference in the cumulative risk of relapse, event-free survival, or overall survival.
Conclusion: BuFlu administration can be employed as a preparative regimen for allogeneic HSCT and shows efficacy and transplant-adverse effects comparable to those of BuCy. However, randomized prospective studies in more patients are warranted.
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KEYWORD
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Myeloablative regimen, Allogeneic hematopoietic stem cell transplantation, Fludarabine, Busulfan
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