Busulfan, cyclophosphamide and total body irradiation as conditioning for allogeneic bone marrow transplantation for acute and chronic myeloid leukemia

• Published in: Bone marrow transplantation (Basingstoke) Vol. 21; no. 11; pp. 1079 - 1083
• Main Authors: HIRABAYASHI, N, GOTO, S, ISHII, M, YUGE, M, MITSUMA, A, NODA, N
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.06.1998
• Subjects: Acute myeloid leukemia; Adolescent; Adult; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Bone marrow; Bone marrow transplantation; Bone Marrow Transplantation - adverse effects; Busulfan; Busulfan - administration & dosage; Child; Child, Preschool; Chronic myeloid leukemia; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Conditioning; Cyclophosphamide; Cyclophosphamide - administration & dosage; Female; Graft vs Host Disease - etiology; Humans; Irradiation; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - mortality; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Leukemia, Myeloid, Acute - mortality; Leukemia, Myeloid, Acute - therapy; Leukemia, Myeloid, Chronic-Phase - mortality; Leukemia, Myeloid, Chronic-Phase - therapy; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Radiation; Recurrence; Remission; Stem cell transplantation; Survival Rate; Toxicity; Transplantation; Transplantation Conditioning - adverse effects; Transplantation Conditioning - methods; Transplantation, Homologous; Whole-Body Irradiation; Antineoplastic agent; Human; Acute; Alkanediol; Hematopoietic cell; Homograft; Malignant hemopathy; Radiotherapy; Myeloproliferative syndrome; Alkanesulfonic acid; Chemotherapy; Chronic; Cyclophosphamide; Oxazaphosphinane derivatives; Nitrogen mustard; Chronic myelocytic leukemia; Bone marrow; Graft; Combined treatment; Busulfan; Whole body; Therapeutic protocol; Acute myelocytic leukemia
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1701244

Fifty patients with acute myeloid leukemia (AML) or chronic myeloid leukemia (CML) underwent allogeneic bone marrow transplantation between October 1988 and January 1997. Patients received 8 mg/kg of busulfan (BU) with 120 mg/kg of cyclophosphamide (CY) followed by 10 Gy of total body irradiation (TBI). Twenty consecutive patients with AML in first remission (n = 9) or CML, in chronic phase (n = 11) entered the study (group I). Thirty consecutive patients with advanced myeloid malignancies including AML (n = 19) and CML (n = 11) also entered the study (group II). The probability of leukemia-free survival at 5 years was 85% for group I patients and 50% for group II patients. Severe regimen-related toxicities occurred in 16% of patients (two in group I, six in group II). The most common sites affected by severe toxicities were lung (n = 6), liver (n = 2) and heart (n = 2). The relapse rate was higher for patients allografted in advanced stages of disease (O% at 5 years for group I and 28% for group II). These results suggest that BU + CY + TBI is a very effective conditioning regimen in patients with myeloid malignancies.