Reduced intensity conditioning regimen with fludarabine, busulfan, and low‐dose TBI (Flu‐BU2‐TBI): Clinical efficacy in high‐risk patients

• Published in: American journal of hematology Vol. 85; no. 4; pp. 243 - 248
• Main Authors: Takahata, Mutsumi, Hashino, Satoshi, Okada, Kohei, Onozawa, Masahiro, Kahata, Kaoru, Sugita, Junichi, Shigematsu, Akio, Kondo, Takeshi, Yamamoto, Satoshi, Endo, Tomoyuki, Nishio, Mitsufumi, Ito, Yoichi M., Tanaka, Junji, Koike, Takao, Asaka, Masahiro, Imamura, Masahiro
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.04.2010; Wiley-Liss
• Subjects: Adult; Aged; Aging; Biological and medical sciences; Busulfan - administration & dosage; Busulfan - therapeutic use; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation; Humans; Medical sciences; Middle Aged; Myeloablative Agonists - therapeutic use; Retrospective Studies; Risk Factors; Severity of Illness Index; Survival Analysis; Transplantation Conditioning - methods; Transplantation, Homologous; Treatment Outcome; Vidarabine - analogs & derivatives; Vidarabine - therapeutic use; Whole-Body Irradiation - methods; Antineoplastic agent; Human; Purine nucleotide; High risk; Total body irradiation; Hematology; Low dose; Treatment efficiency; Alkanediol; Nucleotide analog; Non myeloablative treatment; Alkanesulfonic acid; Alkylating agent; Fludarabine; Antimetabolic; Nitrogen mustard; Fluorine Organic compounds; Busulfan; Therapeutic protocol
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.21630

Reduced intensity conditioning (RIC) regimens are widely used in allogeneic stem cell transplantation (SCT). In this study, we retrospectively investigated the clinical outcomes of RIC with fludarabine (Flu; 180 mg/m2), intravenous busulfan (BU; 6.4 mg/kg) or oral BU (8 mg/kg), and low‐dose total body irradiation (TBI; 4 Gy) (Flu‐BU2‐TBI) in 66 patients (median age: 54.5 years) with various hematological malignancies. Thirty‐eight patients (58%) were high‐risk patients (median age: 56 years). The overall survival rate at 2 years of the high‐risk patients was 64.5%, which was comparable to the survival rate of 70.9% in standard‐risk patients (P = 0.68). The relapse rates at 2 years in the standard‐risk and high‐risk patients were 16 and 28%, respectively, and day 100 treatment‐related mortality rates were 0 and 6%, respectively. The Flu‐BU2‐TBI regimen for high‐risk patients showed therapeutic effects equivalent to those for standard‐risk patients and favorable outcomes compared with those of other previous RIC regimens. Am. J. Hematol., 2010. © 2010 Wiley‐Liss, Inc.