TY - JOUR
T1 - Reduced-intensity conditioning allogeneic blood stem cell transplantation with fludarabine and oral busulfan with or without pharmacokinetically targeted busulfan dosing in patients with myeloid leukemia ineligible for conventional conditioning
AU - Martino, Rodrigo
AU - Pérez-Simón, José A.
AU - Moreno, Estela
AU - Queraltó, José M.
AU - Caballero, Dolores
AU - Mateos, Marivi
AU - Sureda, Anna
AU - Cañizo, Consuelo
AU - Brunet, Salut
AU - Briones, Javier
AU - Vazquez, Lourdes
AU - Clopés, Ana
AU - San Miguel, Jesús F.
AU - Sierra, Jorge
PY - 2005/6/1
Y1 - 2005/6/1
N2 - We prospectively compared outcomes after a fludarabine (Flu) plus oral busulfan (Bu)-containing reduced-intensity conditioning regimen (150 mg/ m2 Flu and 10 mg/kg oral Bu), with (n = 32; Flu-T Bu group) or without (n = 30; Flu-Bu group) therapeutic dose monitoring and dose adjustment of Bu. All patients received peripheral blood stem cells from a genoidentical sibling, and study cohorts had similar patient characteristics. Dose adjustments of Bu were required in 20 (63%) patients in the Flu-TBu group (median final dose, 8.89 mg/kg; range, 6.3-13.34 mg/kg). Donor T-cell and granulocyte engraftments were similar, and early conditioning-related toxicities were mild and similar in both study groups. With a median follow-up of 45 months (51 months in the 37 survivors), posttransplantation outcomes did not differ between cohorts. The strongest predictor of 2-year overall survival and leukemia-free survival was the presence of chronic graft-versus-host disease (77% versus 34% for overall survival and 74% versus 34% for leukemia-free survival; P < .001 for both outcomes). In conclusion, therapeutic dose monitoring of oral Bu in a reduced-intensity conditioning setting does not seem to affect outcome, although further studies may identify very-high-risk patients who benefit from this strategy. © 2005 American Society for Blood and Marrow Transplantation.
AB - We prospectively compared outcomes after a fludarabine (Flu) plus oral busulfan (Bu)-containing reduced-intensity conditioning regimen (150 mg/ m2 Flu and 10 mg/kg oral Bu), with (n = 32; Flu-T Bu group) or without (n = 30; Flu-Bu group) therapeutic dose monitoring and dose adjustment of Bu. All patients received peripheral blood stem cells from a genoidentical sibling, and study cohorts had similar patient characteristics. Dose adjustments of Bu were required in 20 (63%) patients in the Flu-TBu group (median final dose, 8.89 mg/kg; range, 6.3-13.34 mg/kg). Donor T-cell and granulocyte engraftments were similar, and early conditioning-related toxicities were mild and similar in both study groups. With a median follow-up of 45 months (51 months in the 37 survivors), posttransplantation outcomes did not differ between cohorts. The strongest predictor of 2-year overall survival and leukemia-free survival was the presence of chronic graft-versus-host disease (77% versus 34% for overall survival and 74% versus 34% for leukemia-free survival; P < .001 for both outcomes). In conclusion, therapeutic dose monitoring of oral Bu in a reduced-intensity conditioning setting does not seem to affect outcome, although further studies may identify very-high-risk patients who benefit from this strategy. © 2005 American Society for Blood and Marrow Transplantation.
KW - Allogeneic peripheral blood stem cell transplantation
KW - Busulfan pharmacokinetics
KW - Reduced intensity
U2 - https://doi.org/10.1016/j.bbmt.2005.03.003
DO - https://doi.org/10.1016/j.bbmt.2005.03.003
M3 - Article
VL - 11
SP - 437
EP - 447
ER -