High-dose busulfan and the risk of pulmonary mortality after autologous stem cell transplant.
The non-relapse mortality of autologous stem cell transplant is low enough that the procedure has been extended to older patients with non-Hodgkin's lymphoma. We treated 537 non-Hodgkin's lymphoma patients with high-dose chemotherapy consisting of busulfan, cyclophosphamide, and etoposide followed by autologous stem cell transplant. Sixteen patients were identified who died of pulmonary complications at a five-year incidence of 3.6%. Risk factors for pulmonary mortality included older age and lower baseline D(CO) and FEV1. We conclude that high-dose busulfan is associated with pulmonary mortality after autologous transplant, particularly in older patients.
Kalaycio
Matt
M
Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. kalaycm@ccf.org
Pohlman
Brad
B
Kuczkowski
Elizabeth
E
Rybicki
Lisa
L
Andresen
Steve
S
Sobecks
Ronald
R
Bolwell
Brian
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D002066:Busulfan / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008171:Lung Diseases / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D002066:Busulfan