Myeloablative Reduced-Toxicity i.v. Busulfan-Fludarabine and Allogeneic Hematopoietic Stem Cell Transplant for Patients with Acute Myeloid Leukemia or Myelodysplastic Syndrome in the Sixth through Eighth Decades of Life
Myeloablative Reduced-Toxicity i.v. Busulfan-Fludarabine and Allogeneic Hematopoietic Stem Cell Transplant for Patients with Acute Myeloid Leukemia or Myelodysplastic Syndrome in the Sixth through Eighth Decades of Life
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DOI：
10.1016/j.bbmt.2011.02.007
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发表时间：
2011-10-01
影响因子：
4.3
通讯作者：
Andersson, Borje S.
中科院分区：
文献类型：
--
作者：
Alatrash, Gheath;de Lima, Marcos;Andersson, Borje S.
年龄为55岁的急性髓系白血病(AML)或骨髓增生异常综合征(MDS)患者的最佳移植前方案仍有待确定。清髓性减毒4天方案静脉注射。白花丹(Bu)(130 mg/m(2))和静脉注射。氟达拉滨(Flu)(40 mg/m(2))与低发病率和死亡率有关。我们分析了79例AML(n=63)或MDS(n=16)静脉注射治疗的患者，年龄55岁(中位数，58岁)。2001年至2009年期间接受BU-流感调理疗法(中位数随访，24个月)。接受该方案治疗的患者表现良好。移植时首次完全缓解(CR1)、第二次完全缓解(CR2)或难治性疾病患者的2年总生存率(OS)分别为71%、44%、32%和46%，移植时CR1、CR2或难治性疾病患者和全部患者的2年无事件生存率(EFS)分别为68%、42%、30%和44%。移植时处于完全缓解期或疾病活动性的患者一年的移植相关死亡率(TRM)分别为19%和20%。40%的患者被诊断为II-IV级急性移植物抗宿主(AGVHD)疾病。我们的结果表明，年龄本身不应该是排除接受静脉注射清髓性减毒调节的主要原因。BU-Flu在AML/MDS患者移植前的应用生物骨髓移植17：1490-1496(2011)(C)2011年美国血液和骨髓移植学会
The optimal pretransplant regimen for acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) in patients >= 55 years of age remains to be determined. The myeloablative reduced-toxicity 4-day regimen i.v. busulfan (Bu) (130 mg/m(2)) and i.v. fludarabine (Flu) (40 mg/m(2)) is associated with low morbidity and mortality. We analyzed 79 patients >= 55 years of age (median, 58 years) with AML (n = 63) or MDS (n = 16) treated with i.v. Bu-Flu conditioning regimens between 2001 and 2009 (median follow-up, 24 months). The patients who received this regimen had a good performance status. The 2-year overall survival (OS) rates for patients in first complete remission (CR1), second CR (CR2), or refractory disease and for all patients at time of transplantation were 71%, 44%, 32%, and 46%, respectively; 2-year event-free survival (EFS) rates for patients in CR1, CR2, or refractory disease at time of transplantation and for all patients were 68%, 42%, 30%, and 44%, respectively. One-year transplant-related mortality (TRM) rates for patients who were in CR or who had active disease at the time of transplantation were 19% and 20%, respectively. Grade II-IV acute graft-versus-host (aGVHD) disease was diagnosed in 40% of the patients. Our results suggest that age alone should not be the primary reason for exclusion from receiving myeloablative reduced-toxicity conditioning with i.v. Bu-Flu preceding transplantation in patients with AML/MDS. Biol Blood Marrow Transplant 17: 1490-1496 (2011) (C) 2011 American Society for Blood and Marrow Transplantation