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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ÀÌÁöÇö(Lee Ji-Hyun) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÃÖÁö¹Î(Choi Ji-min) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ µ¿¾ÆÀÇ·á¿ø ÀÓ»ó½ÇÇè½Ç
±Ç°æ¾Æ(Kwon Kyung-A) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
À̼ö(Lee Suee) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
¿À¼º¿ë(Oh Sung-Yong) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±ÇÇõÂù(Kwon Hyuk-Chan) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èÈ¿Áø(Kim Hyo-Jin) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÇÑÁø¿µ(Han Jin-Young) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ÀÓ»óº´¸®Çб³½Ç
±è¼ºÇö(Kim Sung-Hyun) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¾ÏºÐÀÚÄ¡·á¿¬±¸¼¾ÅÍ

Abstract

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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Myeloablative regimen, Allogeneic hematopoietic stem cell transplantation, Fludarabine, Busulfan
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