title: Allogeneic hematopoietic SCT for adults AML using i.v. BU in the conditioning regimen: outcomes and risk factors for the occurrence of hepatic sinusoidal obstructive syndrome.
abstract: I.v. BU is frequently used in the conditioning regimen prior to allogeneic hematopoietic SCT (allo-HSCT); however, overall outcomes, incidence of hepatic sinusoidal obstructive syndrome (SOS) and its risk factors are not well known. With this aim, we performed a study on 257 AML adult recipients. Seattle Criteria were used for diagnosis and classification of SOS. The median age was 44 years. Donors were HLA-identical siblings in 60%, HLA-matched unrelated in 29% and HLA mismatched in 11%. Conditioning regimen was myeloablative in 84% (i.v. BU with CY was the most frequently used regimen) and it was reduced intensity in 16% (i.v. BU associated with fludarabine). Acute and chronic GVHD was observed in 28% and 44%, respectively. Two-year incidence of non-relapse mortality was 16±2% and 2-year leukemia-free survival for patients in CR1, CR2 and non remission at HSCT were 55±4%, 58±7%, and 20±5%, respectively. At 6 months, incidence of SOS was 7.8±2%; and it was severe in eight patients (3%). Factors associated with the occurrence of SOS were: HLA-mismatched donor HSCT (P=0.002) and patients transplanted in non-remission (P=0.002). In conclusion, outcomes of HSCT using i.v. BU are encouraging in this setting, SOS incidence is low and it is influenced by the type of donor and disease status at the time of transplant.
authors.affiliation: Hematology Division and Institute of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Nagler
authors.affiliation: EBMT Acute Leukemia Working Party and Registry, Hospital Saint-Antoine, Paris University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.affiliation: Hematology Division and Institute of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Berger
authors.affiliation: Klinik fuer Innere Medzin III, Universitätsklinikum, Ulm, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Bunjes
authors.affiliation: Instituto Portugues de Oncologia do Porto, BMT Unit, Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Campos
authors.affiliation: Hopital St Louis, Department of Hematology-BMT, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Socié
authors.affiliation: Bone Marrow Transplantation Centre, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Kröger
authors.affiliation: Department of Hematology, BMT Unit, Hacettepe University, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Goker
authors.affiliation: Bone Marrow Transplant Unit, Hôpital Huriez, Lille, France.
authors.forename: I
authors.initials: I
authors.lastname: Yakoub-Agha
authors.affiliation: Hematology Division and Institute of Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shimoni
authors.affiliation: EBMT Acute Leukemia Working Party and Registry, Hospital Saint-Antoine, Paris University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Haematology Department, Bone Marrow Transplant Unit, Churchill Hospital, Oxford University Hopitals, Oxford, UK.
authors.forename: V
authors.initials: V
authors.lastname: Rocha
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D002066:Busulfan / Q000008:administration & dosage*; D016208:Databases, Factual / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006504:Hepatic Veno-Occlusive Disease / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D002066:Busulfan