title: Oral versus intravenous fludarabine as part of a reduced-intensity conditioning for allogeneic stem cell transplantation.
abstract: BACKGROUND
  In 2003, oral fludarabine was introduced in the USA for the treatment of patients with hematologic malignancies as an alternative to its intravenous (i.v.) formulation; in 2008, it was introduced in México while the i.v. formulation was withdrawn. Accordingly, i.v. fludarabine had to be replaced by oral fludarabine as part of the conditioning regimen employed to conduct allogeneic stem cell transplantation in México.
  
  
  METHODS
  Nonrandomized retrospective analysis of 55 patients conditioned with oral fludarabine compared with 113 patients conditioned with the i.v. formulation. In addition to fludarabine, the conditioning regimen included oral busulfan and i.v. cyclophosphamide. Donors were HLA-matched siblings.
  
  
  RESULTS
  The clinical features of the two groups were comparable. There were no statistical differences in time to neutrophil engraftment, time to platelet engraftment, acute graft versus host disease rate and nonrelapse mortality at day 100. The overall survival of patients allografted with oral fludarabine was better than those allografted with i.v. fludarabine: 62 and 33% at 67 months, respectively (p = 0.0006).
  
  
  CONCLUSIONS
  Oral fludarabine can replace its i.v. formulation as part of reduced-intensity conditioning regimens with no deleterious effect on any of the early transplantation outcomes.
authors.affiliation: Centro de Hematología y Medicina Interna, Clínica Ruiz, Puebla, Mexico.
authors.forename: Sara
authors.initials: S
authors.lastname: Velázquez-Sánchez-de-Cima
authors.forename: Gabriela
authors.initials: G
authors.lastname: Zamora-Ortiz
authors.forename: Jesús
authors.initials: J
authors.lastname: Hernández-Reyes
authors.forename: Alan Daniel
authors.initials: AD
authors.lastname: Rosales-Durón
authors.forename: Mónica Patricia
authors.initials: MP
authors.lastname: González-Ramírez
authors.forename: Nora Angela
authors.initials: NA
authors.lastname: Martagón-Herrera
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Delgado
authors.forename: Guillermo J
authors.initials: GJ
authors.lastname: Ruiz-Argüelles
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D055815:Young Adult
chemical_list: D019653:Myeloablative Agonists; D014740:Vidarabine; C024352:fludarabine