Faculty Collaboration Database

Long term follow-up of allogeneic stem cell transplantation in patients with myelodysplastic syndromes using busulfan, cytosine arabinoside, and cyclophosphamide. Am J Hematol 2010 Aug;85(8):579-83

Date

06/26/2010

Pubmed ID

20578198

Pubmed Central ID

PMC3800118

DOI

10.1002/ajh.21761

Scopus ID

2-s2.0-77955480515 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

We report here the 10-year follow-up of 86 patients who underwent allogeneic stem cell transplantation (ASCT) for myelodysplastic syndrome (MDS). All patients received the busulfan, cytosine arabinoside, and cyclophosphamide (BAC) preparative regimen which consisted of busulfan 16 mg/kg, cytosine arabinoside 8 g/m(2) IV, and cyclophosphamide 120 mg/kg IV. Fifty-nine patients (69%) had de novo MDS; 26 (30%) had secondary MDS (treatment related), and one had a preceding aplastic anemia which progressed to MDS before transplant. Cytogenetics (80 patients) was classified as good (34%), intermediate (17%), or poor (42%). With a median follow-up for survivors of 124 months, the 10-year Kaplan-Meier estimates for overall survival (OS) was 43% (95% confidence interval [CI]: 31-53%). Cumulative nonrelapse mortality (NRM) and relapse was 43% (95% CI: 32-54%) and 19% (95% CI: 11-27%), respectively. No patient relapsed after 2 years. In patients with RAEB-T/AML, 10-year relapse-free survival (RFS), relapse, and NRM was 36%, 36%, and 27%, respectively. Younger age (P = 0.05), human leukocyte antigen (HLA) match (P = 0.002), good risk cytogenetics (P = 0.008), and having a related donor (P = 0.03) significantly improved overall and RFS in the multivariable analysis. The long-term follow-up of patients receiving the BAC regimen with ASCT in this study indicated durable relapse-free and OS with acceptable toxicity in this group of patients with high-risk features.

Author List

Atallah E, Abrams J, Ayash L, Bentley G, Abidi M, Ratanatharathorn V, Uberti J

Author

Ehab L. Atallah MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Busulfan
Cyclophosphamide
Cytarabine
Disease-Free Survival
Female
Follow-Up Studies
Graft vs Host Disease
Humans
Immunosuppressive Agents
Kaplan-Meier Estimate
Male
Middle Aged
Myeloablative Agonists
Myelodysplastic Syndromes
Postoperative Complications
Recurrence
Retrospective Studies
Stem Cell Transplantation
Transplantation Conditioning
Transplantation, Homologous
Treatment Outcome
Young Adult