title: [Transplant-Related Mortality Following Allogeneic Hematopoietic Stem Cell Transplantation Using Fludarabine/Busulfan-Based Reduced-Intensity Conditioning - A Retrospective Analysis in a Single Institution].
abstract: Reduced-intensity conditioning (RIC) has been shown to facilitate allogeneichematopoieticstem cell transplantation (allo-HSCT) for patients with comorbidities and the elderly. However, there are some concerns about transplant-related mortality (TRM). We retrospectively analyzed 37 consecutive patients who received allo-HSCT using RIC from January 2005 to December 2012 in our hospital. All patients received fludarabine(FLU), 180 mg/m2, and intravenous busulfan(BU), 6.4 mg/ kg (or oral BU 8 mg/kg), with or without TBI (2 or 4 Gy). Cyclosporine or tacrolimus alone, or in combination with shortterm methotrexate therapy was used for GVHD prophylaxis. Donor sources included related peripheral blood donors (n=4), and related (n=8) and unrelated (n=25) bone marrow donors. The underlying diseases were various, and 27 patients were considered to be at standard risk. Although one patient died of early disease progression, engraftment was achieved for the others. With a median follow-up of 28.5 months, the estimated 1-year and 5-year TRMs were 13% and 20%, respectively. Five patients died of transplant-related complications, which consisted of 2 cases of acute GVHD and 1 case each of interstitial pneumonitis, bronchiolitis obliterans, and infectious pneumonia. In conclusion, FLU/BU-based RIC is tolerable, but further optimization is needed to prevent transplant-related complications.
authors.affiliation: Dept. of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kusumoto
authors.forename: Arisa
authors.initials: A
authors.lastname: Masuda
authors.forename: Haruhito
authors.initials: H
authors.lastname: Totani
authors.forename: Tomoko
authors.initials: T
authors.lastname: Narita
authors.forename: Ayako
authors.initials: A
authors.lastname: Masaki
authors.forename: Asahi
authors.initials: A
authors.lastname: Ito
authors.forename: Masaki
authors.initials: M
authors.lastname: Ri
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Komatsu
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Iida
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D002066:Busulfan / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006086:Graft vs Host Disease / Q000517:prevention & control; D006402:Hematologic Diseases / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine