title: Comparing i.v. BU dose intensity between two regimens (FB2 vs FB4) for allogeneic HCT for AML in CR1: a report from the Acute Leukemia Working Party of EBMT.
abstract: This retrospective analysis compared two regimens of fludarabine combined with i.v. BU 6.4 mg/kg (FB2) or BU 12.8 mg/kg (FB4) for allografting of AML in first CR. A total of 437 patients (median age: 50 years) were administered FB2 (n = 225, 51%) or FB4 (n = 212, 49%). Median follow-up time was 28 months. Use of FB2 resulted in a longer time to neutrophil engraftment (17 vs 15 days, P < 0.0001) but no difference in incidence of grade II-IV acute (P = 0.54) or chronic GVHD (P = 0.51). In patients < 50 years of age, FB2 was associated with a higher 2-year cumulative incidence of relapse (33 ± 6% vs 20 ± 4%, P = 0.04), but there was no difference in 2-year leukemia-free survival (LFS) (P = 0.45), OS (P = 0.53) or non-relapse mortality (P = 0.17). In recipients ⩾ 50 years of age, FB2 resulted in better 2-year LFS (63 ± 4% vs 42 ± 7%, P = 0.02) and OS (68 ± 4% vs 45 ± 7%, P = 0.006); a lower 2-year non-relapse mortality, albeit not statistically significant (15 ± 3% vs 29 ± 6%, P = 0.06), was observed with FB2. FB2 is an effective and well-tolerated regimen in patients ⩾ 50 years of age and does not compromise survival when used in patients <50 years undergoing allogeneic transplantation for AML in first CR.
authors: 1] Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center/University of South Florida College of Medicine, Tampa, Florida, USA [2] Division of Hematology-Oncology and Bone Marrow Transplantation Program, American University of Beirut Medical Center, Beirut, Lebanon.
authors: M A
authors: MA
authors: Kharfan-Dabaja
authors: Acute Leukemia Working Party of EBMT, Paris, France.
authors: M
authors: M
authors: Labopin
authors: Division of Hematology-Oncology and Bone Marrow Transplantation Program, American University of Beirut Medical Center, Beirut, Lebanon.
authors: A
authors: A
authors: Bazarbachi
authors: Centre Pierre et Marie Curie, Alger, Algeria.
authors: R M
authors: RM
authors: Hamladji
authors: Unité de Transplantation et de Thérapie Cellulaire (U2T), Institut Paoli-Calmettes, Marseille, France.
authors: D
authors: D
authors: Blaise
authors: Service d'Hématologie Greffe, Hôpital Saint Louis, Paris, France.
authors: G
authors: G
authors: Socié
authors: CHU Hautepierre- Département d'Hématologie et Oncologie, Strasbourg, France.
authors: B
authors: B
authors: Lioure
authors: Department of Hematology, Hospital Universitario Marqués de Valdecilla, Instituto de Formación e Investigación Marqués de Valdecilla, Santander, Spain.
authors: A
authors: A
authors: Bermudez
authors: Servicio de Hematologia, Hospital Universitario de Salamanca, Salamanca, Spain.
authors: L
authors: L
authors: Lopez-Corral
authors: Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah University Hospital, Jerusalem, Israel.
authors: R
authors: R
authors: Or
authors: Rome Transplant Network, Department of Hematology, Stem Cell Transplant Unit, Tor Vergata University, Rome, Italy.
authors: W
authors: W
authors: Arcese
authors: Service d'Hématologie, CHU, Montpellier, France.
authors: N
authors: N
authors: Fegueux
authors: Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors: A
authors: A
authors: Nagler
authors: 1] Acute Leukemia Working Party of EBMT, Paris, France [2] Département d'Hématologie, Hopital Saint Antoine, Paris, France.
authors: M
authors: M
authors: Mohty
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D002066:Busulfan / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D002066:Busulfan