title: [Effect of BU and CY versus TBI and CY as conditioning regimens on the efficacy of haploidentical stem cell transplantation in patients with hematologic malignancy].
abstract: OBJECTIVE
  To investigate the therapeutic effects of the conditioning regimen with busulfan plus cyclophosphamide (BU+CY) or total body irradiation plus cyclophosphamide (TBI+CY) on haploidentical stem cell transplantation (HSCT) in hematologic malignancy.
  
  
  METHODS
  The clinical outcomes of 77 HSCT recipients with hematologic malignancy from January 2001 to December 2010, including 21 AML, 33 ALL, 19 CML and 4 MDS were retrospectively evaluated. Among them, 65 patients obtained complete remission (CR) and 12 non-remission (NR) before transplantation; 39 patients received conditioning regimen with BU+CY, and 38 with TBI+CY.
  
  
  RESULTS
  There were no statistically significant differences in hematopoietic reconstitution, disease free survival (DFS), and transplant- related mortality (TRM) between two groups. The estimated 3- years overall survival (OS) was 56.4% for BU+CY and 31.6% for TBI + CY (P=0.0283). The overall relapse rate was similar between two groups (15.4% vs 34.2%; P=0.1538). However, the accumulative probability of relapse at 1-year was significantly lower in BU+CY than that in TBI+CY group (2.56% vs 26.67%; P=0.0116). The incidence of grade II-IV graft-versus-host disease (GVHD) was similar between two regimens (20.5% in BU+CY group and 18.4% in TBI+CY group; P=0.8168). The incidence of chronic GVHD (cGVHD) was higher in the TBI+CY group than that of BU+CY group (84.6% vs 41.1%; P=0.0007). The extensive GVHD obtained the similar outcome (30.8% vs 10.5%; P=0.0416).
  
  
  CONCLUSIONS
  Patients using BU+CY as conditioning regimen before transplant could obtain a better 3 year OS and lower short-term relapse rate. The TBI+CY conditioning regimen could significantly increase the incidence of cGVHD without increasing the acute GVHD. BU+CY conditioning regimen could be used for HSCT, but the attention should be paid to prevent the related hemorrhagic cystitis.
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Shao
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Han
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Danbo
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Dong
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ding
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Hongmin
authors.initials: H
authors.lastname: Yan
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Hengxiang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Hematology, the Air Force General Hospital of Anhui Medical College, Beijing 100142, China.
authors.forename: Lianning
authors.initials: L
authors.lastname: Duan
mesh_terms: D000293:Adolescent; D000328:Adult; D002066:Busulfan / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014916:Whole-Body Irradiation; D055815:Young Adult
chemical_list: D003520:Cyclophosphamide; D002066:Busulfan