Myeloablative busulfan/cytoxan conditioning versus reduced-intensity fludarabine/melphalan conditioning for allogeneic hematopoietic stem cell transplant in patients with acute myelogenous leukemia. Issue 4 (3rd April 2018)

• Record Type: Journal Article
• Authors: Dhere, Vishal; Edelman, Scott; Waller, Edmund K.; Langston, Amelia; Graiser, Michael; Connolly, Erin C.; Switchenko, Jeffrey M.; Esiashvili, Natia; Khan, Mohammad K.
• Is Part Of: Leukemia & lymphoma. Volume 59:Issue 4(2018)
• Page Start: 837
• Page End: 843
• Publication Date: 2018-04-03
• Subjects: Transplant toxicity -- chemotherapeutic approaches -- myeloid leukemias and dysplasias; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2017.1361027
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Fludarabine and melphalan (Flu/Mel) has emerged as a more tolerable chemotherapy-based conditioning regimen compared with busulfan and cyclophosphamide (Bu/Cy) for allogeneic stem cell transplant (allo-hematopoietic stem cell transplantation (HSCT)) patients with acute myelogenous leukemia (AML). We conducted a retrospective review of a single-institution database including patients with AML who received allo-HSCT following conditioning with Mel/Flu or Bu/Cy-based regimens. We performed descriptive statistical analysis to examine patient demographics and clinical outcomes. We identified 156 patients meeting criteria between 2005 and 2014. Overall, patients conditioned with Bu/Cy were significantly younger, but more likely to be treated in an earlier era than those receiving Flu/Mel. Regimen choice was not associated with relapse rates (RR), relapse-free survival (RFS), or overall survival (OS) on both univariate and multivariable analyses. Bu/Cy was associated with increased non-relapse mortality (NRM) on multivariable analysis. These findings demonstrate that Flu/Mel provides non-inferior disease control and could be an appropriate regimen for selected patients.