Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Academic Article uri icon

Overview

MeSH

  • Acute Disease
  • Adolescent
  • Adult
  • Busulfan
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cyclophosphamide
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Remission Induction
  • Siblings
  • Time Factors
  • Transplantation, Homologous
  • Treatment Outcome
  • Unrelated Donors
  • Young Adult

MeSH Major

  • Antineoplastic Combined Chemotherapy Protocols
  • Hematopoietic Stem Cell Transplantation
  • Leukemia, Myeloid
  • Whole-Body Irradiation

abstract

  • Cyclophosphamide combined with total body irradiation (Cy/TBI) or busulfan (BuCy) are the most widely used myeloablative conditioning regimens for allotransplants. Recent data regarding their comparative effectiveness are lacking. We analyzed data from the Center for International Blood and Marrow Transplant Research for 1230 subjects receiving a first hematopoietic cell transplant from a human leukocyte antigen-matched sibling or from an unrelated donor during the years 2000 to 2006 for acute myeloid leukemia (AML) in first complete remission (CR) after conditioning with Cy/TBI or oral or intravenous (IV) BuCy. Multivariate analysis showed significantly less nonrelapse mortality (relative risk [RR] = 0.58; 95% confidence interval [CI]: 0.39-0.86; P = .007), and relapse after, but not before, 1 year posttransplant (RR = 0.23; 95% CI: 0.08-0.65; P = .006), and better leukemia-free survival (RR = 0.70; 95% CI: 0.55-0.88; P = .003) and survival (RR = 0.68; 95% CI: 0.52-0.88; P = .003) in persons receiving IV, but not oral, Bu compared with TBI. In combination with Cy, IV Bu is associated with superior outcomes compared with TBI in patients with AML in first CR.

authors

publication date

  • December 5, 2013

has subject area

  • Acute Disease
  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols
  • Busulfan
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cyclophosphamide
  • Disease-Free Survival
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia, Myeloid
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Remission Induction
  • Siblings
  • Time Factors
  • Transplantation, Homologous
  • Treatment Outcome
  • Unrelated Donors
  • Whole-Body Irradiation
  • Young Adult

Research

keywords

  • Journal Article

Identity

Language

  • eng

PubMed Central ID

  • PMC3854108

Digital Object Identifier (DOI)

  • 10.1182/blood-2013-07-514448

PubMed ID

  • 24065243

Additional Document Info

start page

  • 3863

end page

  • 3870

volume

  • 122

number

  • 24