TY - JOUR
T1 - Intravenous BU plus Mel
T2 - An effective, chemotherapy-only transplant conditioning regimen in patients with ALL
AU - Kebriaei, P.
AU - Madden, T.
AU - Wang, X.
AU - Thall, P. F.
AU - Ledesma, C.
AU - De Lima, M.
AU - Shpall, E. J.
AU - Hosing, C.
AU - Qazilbash, M.
AU - Popat, U.
AU - Alousi, A.
AU - Nieto, Y.
AU - Champlin, R. E.
AU - Jones, R. B.
AU - Andersson, B. S.
PY - 2013/1
Y1 - 2013/1
N2 - We investigated the administration of i.v. BU combined with melphalan (Mel) in patients with ALL undergoing allogeneic hematopoietic SCT. Forty-seven patients with a median age of 33 years (range 20-61) received a matched sibling (n=27) or matched unrelated donor transplant (n=20) for ALL in first CR (n=26), second CR (n=13), or with more advanced disease (n=8). BU was infused daily for 4 days, either at a fixed dose of 130 mg/m 2 (5 patients) or using pharmacokinetic (PK) dose adjustment (42 patients), to target an average daily area-under-the-curve (AUC) of 5000 μmol/min, determined by a test dose of i.v. BU at 32 mg/m 2. This was followed by a rest day, then two daily doses of Mel at 70 mg/m 2. Stem cells were infused on the following day. The 2-year OS, PFS and non-relapse mortality (NRM) rates were 35% (95% confidence interval (CI), 23-51%), 31% (95% CI, 21-48%) and 37% (95% CI, 23-50%), respectively. Acute NRM at 100 days was favorable at 12% (95% CI, 5-24%); however, the 2-year NRM was significantly higher for patients older than 40 years, 58% vs 20%, mainly due to GVHD.
AB - We investigated the administration of i.v. BU combined with melphalan (Mel) in patients with ALL undergoing allogeneic hematopoietic SCT. Forty-seven patients with a median age of 33 years (range 20-61) received a matched sibling (n=27) or matched unrelated donor transplant (n=20) for ALL in first CR (n=26), second CR (n=13), or with more advanced disease (n=8). BU was infused daily for 4 days, either at a fixed dose of 130 mg/m 2 (5 patients) or using pharmacokinetic (PK) dose adjustment (42 patients), to target an average daily area-under-the-curve (AUC) of 5000 μmol/min, determined by a test dose of i.v. BU at 32 mg/m 2. This was followed by a rest day, then two daily doses of Mel at 70 mg/m 2. Stem cells were infused on the following day. The 2-year OS, PFS and non-relapse mortality (NRM) rates were 35% (95% confidence interval (CI), 23-51%), 31% (95% CI, 21-48%) and 37% (95% CI, 23-50%), respectively. Acute NRM at 100 days was favorable at 12% (95% CI, 5-24%); however, the 2-year NRM was significantly higher for patients older than 40 years, 58% vs 20%, mainly due to GVHD.
KW - ALL
KW - Allogeneic hematopoietic SCT
KW - BU
UR - http://www.scopus.com/inward/record.url?scp=84872163944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84872163944&partnerID=8YFLogxK
U2 - 10.1038/bmt.2012.114
DO - 10.1038/bmt.2012.114
M3 - Article
C2 - 22732703
AN - SCOPUS:84872163944
SN - 0268-3369
VL - 48
SP - 26
EP - 31
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 1
ER -