title: Busulfan and cyclophosphamide (Bu/Cy) as a preparative regimen for autologous stem cell transplantation in patients with non-Hodgkin lymphoma: a single-institution experience.
abstract: High-dose chemotherapy with autologous stem cell transplantation (ASCT) has been established as a standard form of therapy for patients with non-Hodgkin lymphoma (NHL). While many high-dose chemotherapy combinations are used, no single regimen has proved superior over another. Here, we report our single center's experience in patients with NHL undergoing ASCT with the combination of busulfan and cyclophosphamide (Bu/Cy). This study is a retrospective analysis of 78 consecutive patients with NHL who underwent ASCT with Bu/Cy at Massachusetts General Hospital Cancer Center. Data were collected through review of electronic medical records. A total of 78 patients with NHL underwent ASCT with Bu/Cy preparative therapy between 1996 and 2006. Median follow-up for survivors was 5.0 years (range, 6 months to 12 years). Significant transplantation-associated complications included 9 documented bacterial infections, 4 cases of engraftment syndrome, 3 cases of hepatic veno-occlusive disease (VOD), 6 cases of cardiac complications, and 2 cases of pulmonary fibrosis. The 100-day treatment-related mortality (TRM) was 1%. At 3 years, progression-free survival (PFS) was 48% (95% confidence interval [CI]=37% to 59%) and overall survival (OS) was 65% (95% CI=53% to 74%). Our data indicate that in patients with NHL undergoing ASCT, Bu/Cy has efficacy and toxicity comparable to that of other reported regimens.
authors.affiliation: Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Ulrickson
authors.forename: Julie
authors.initials: J
authors.lastname: Aldridge
authors.forename: Haesook T
authors.initials: HT
authors.lastname: Kim
authors.forename: Ephraim P
authors.initials: EP
authors.lastname: Hochberg
authors.forename: Peter
authors.initials: P
authors.lastname: Hammerman
authors.forename: Christine
authors.initials: C
authors.lastname: Dube
authors.forename: Eyal
authors.initials: E
authors.lastname: Attar
authors.forename: Karen K
authors.initials: KK
authors.lastname: Ballen
authors.forename: Bimalangshu R
authors.initials: BR
authors.lastname: Dey
authors.forename: Steven L
authors.initials: SL
authors.lastname: McAfee
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Spitzer
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology; D002066:Busulfan / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006504:Hepatic Veno-Occlusive Disease / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007239:Infections / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016879:Salvage Therapy; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D014182:Transplantation, Autologous; D055815:Young Adult
chemical_list: D019653:Myeloablative Agonists; D003520:Cyclophosphamide; D002066:Busulfan