Comparative analysis of BU and CY versus CY and TBI in full intensity unrelated marrow donor transplantation for AML, CML and myelodysplasia.
Comparative analysis of BU and CY versus CY and TBI in full intensity unrelated marrow donor transplantation for AML, CML and myelodysplasia.
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DOI：
10.1038/bmt.2010.81
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发表时间：
2011-01
影响因子：
4.8
通讯作者：
Rizzo JD
中科院分区：
文献类型：
--
作者：
Uberti JP;Agovi MA;Tarima S;Haagenson M;Gandham S;Anasetti C;Baker KS;Bolwell BJ;Bornhauser M;Chan KW;Copelan E;Davies SM;Finke J;Hale GA;Kollman C;McCarthy PL;Ratanatharathorn V;Ringdén O;Weisdorf DJ;Rizzo JD
我们回顾比较了1593例急性髓系白血病、骨髓增生异常综合征和慢性粒细胞白血病患者的T-重复URD骨髓移植患者的临床结果，这些患者接受了白花丹和环磷酰胺(Bucy)、标准剂量Cy/TBI(1,000-1,260 cGy)或大剂量Cy/TBI(1,320-1,500 cGy)的清髓预适应方案。受试者来自1991年至1999年间由国家骨髓捐赠者计划(NMDP)促成的移植患者。与BUCY或标准剂量TBI组患者相比，接受高剂量Cy/TBI方案的患者略年轻，更有可能接受不匹配的移植，并患有中晚期疾病。标准剂量CY/TBI组中性粒细胞恢复率明显高于大剂量Cy/TBI组或BUY组。与接受BUCY的对照组相比，接受大剂量Cy/TbI方案的患者发生III-IV级移植物抗宿主病的风险增加(p=0.011)。两种方案的总存活率(OS)、无病存活率(DFS)、移植相关死亡率(TRM)和复发率均无显著差异。我们得出结论：BUCY、标准剂量和大剂量Cy/TBI方案在接受T全URD骨髓移植治疗AML、CML和MDS患者的OS、DFS、TRM和复发风险方面具有同等的疗效。
We retrospectively compared clinical outcomes in 1593 T-repleted URD marrow transplant recipients with AML, MDS and CML who received myeloablative conditioning regimens of either busulfan and cyclophosphamide (BuCy), standard-dose Cy/TBI (1,000-1,260 cGy) or high-dose Cy/TBI (1,320-1,500 cGy). Subjects were drawn from patients transplanted between 1991 and 1999 facilitated by the National Marrow Donor Program (NMDP). Patients who received high-dose Cy/TBI regimens were slightly younger, more likely to receive a mismatched transplant and to have intermediate or advanced disease compared to patients in the BuCy or standard-dose TBI group. Neutrophil recovery was significantly higher in the standard dose CY/TBI group compared to the high-dose Cy/TBI or BuCy group. Patients who received the high-dose Cy/TBI regimen had an increased risk of developing grade III-IV aGVHD when compared to the control group who received BuCy (p=0.011). Overall survival (OS), disease free survival (DFS), transplant-related mortality (TRM) and relapse were not significantly different between any of the regimens. We conclude that BuCy, standard-dose and high dose Cy/TBI regimens have equivalent efficacy profiles for OS, DFS, TRM and relapse risk in patients undergoing T-replete URD marrow transplantation for AML, CML and MDS.
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影响因子：
158.5
作者：
KERNAN, NA;BARTSCH, G;BLUME, KG
通讯作者：
BLUME, KG
影响因子：
4.3
作者：
Farag, Sherif S.;Bacigalupo, Andrea;Davies, Stella M.
通讯作者：
Davies, Stella M.
影响因子：
39.2
作者：
MCDONALD, GB;HINDS, MS;CLIFT, RA
通讯作者：
CLIFT, RA
影响因子：
20.3
作者：
Ruutu, T;Eriksson, B;Ringdén, O
通讯作者：
Ringdén, O
影响因子：
20.3
作者：
DEVERGIE, A;BLAISE, D;GLUCKMAN, E
通讯作者：
GLUCKMAN, E