Comparative analysis of BU and CY versus CY and TBI in full intensity unrelated marrow donor transplantation for AML, CML and myelodysplasia. Bone Marrow Transplant 2011 Jan;46(1):34-43
Date
04/20/2010Pubmed ID
20400989Pubmed Central ID
PMC3169009DOI
10.1038/bmt.2010.81Scopus ID
2-s2.0-78651346532 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
We retrospectively compared clinical outcomes in 1593 T-replete unrelated donor (URD) marrow transplant recipients with AML, MDS and CML who received myeloablative conditioning regimens of either BU and CY (BuCy), standard-dose Cy/TBI (1000-1260 cGy) or high-dose Cy/TBI (1320-1500 cGy). Subjects were drawn from patients transplanted between 1991 and 1999 facilitated by the National Marrow Donor Program. 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 with patients in the BuCy or standard-dose TBI group. Neutrophil recovery was significantly higher in the standard-dose CY/TBI group compared with the high-dose Cy/TBI or BuCy group. Patients who received the high-dose Cy/TBI regimen had an increased risk of developing grades III-IV aGVHD when compared with the control group who received BuCy (P = 0.011). OS, disease-free survival (DFS), 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.
Author List
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 JDAuthors
J. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of WisconsinSergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Antineoplastic Combined Chemotherapy Protocols
Bone Marrow Transplantation
Busulfan
Child
Child, Preschool
Combined Modality Therapy
Cyclophosphamide
Female
Humans
Infant
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Leukemia, Myeloid, Chronic-Phase
Male
Middle Aged
Myeloablative Agonists
Myelodysplastic Syndromes
Retrospective Studies
Transplantation Conditioning
Treatment Outcome
Whole-Body Irradiation
Young Adult
