title: The efficacy and safety of a new reduced-toxicity conditioning with 4 days of once-daily 100 mg/m(2) intravenous busulfan associated with fludarabine and antithymocyte globulins prior to allogeneic stem cell transplantation in patients with high-risk myelodysplastic syndrome or acute leukemia.
abstract: The optimal intensity of myeloablation associated with a reduced-toxicity conditioning (RTC) regimen in order to decrease the relapse rate without increasing non-relapse mortality (NRM), is not well established yet. This retrospective analysis was done on 30 patients with hematological malignancies. The aim was to assess the safety of a RTC regimen based on the busulfan at a dose of 100 mg/m(2)/d intravenously for 4 d, fludarabine at a dose of 30 mg/m(2)/d for 5 d, and anti-thymoglobulins at a dose of 2.5 mg/kg/d for 2 d. The cumulative incidences of grade 2-4 acute graft-versus-host disease (GVHD) and all grades chronic GVHD were 37% and 42%, respectively. Median 1-year overall survival and disease-free survival were 66% and 50%, respectively. At 1 year, the cumulative incidence of relapse/disease progression was 33%. NRM was 3% and 17% at day 100 and 1 year, respectively. This RTC conditioning regimen can lead to a long-term disease control. Moreover, it appears to be safe with a low NRM rate among high-risk patients.
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Anne
authors.initials: A
authors.lastname: Wanquet
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Roberto
authors.initials: R
authors.lastname: Crocchiolo
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Sabine
authors.initials: S
authors.lastname: Furst
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Angela
authors.initials: A
authors.lastname: Granata
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Catherine
authors.initials: C
authors.lastname: Faucher
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Raynier
authors.initials: R
authors.lastname: Devillier
authors.affiliation: c Centre de Thérapie Cellulaire , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Samia
authors.initials: S
authors.lastname: Harbi
authors.affiliation: c Centre de Thérapie Cellulaire , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Claude
authors.initials: C
authors.lastname: Lemarie
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Boris
authors.initials: B
authors.lastname: Calmels
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Norbert
authors.initials: N
authors.lastname: Vey
authors.affiliation: c Centre de Thérapie Cellulaire , Institut Paoli-Calmettes , Marseille , France.
authors.forename: Pierre Jean
authors.initials: PJ
authors.lastname: Weiller
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Christian
authors.initials: C
authors.lastname: Chabannon
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Luca
authors.initials: L
authors.lastname: Castagna
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
authors.affiliation: a Département d'Onco-Hématologie , Institut Paoli-Calmettes , Marseille , France ;|b Unité de Transplantation et de Thérapie Cellulaire (U2T) , Institut Paoli-Calmettes , Marseille , France ;
authors.forename: Jean
authors.initials: J
authors.lastname: El-Cheikh
mesh_terms: D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002066:Busulfan / Q000008:administration & dosage; D015897:Comorbidity; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; C512542:thymoglobulin; D014740:Vidarabine; D002066:Busulfan; C024352:fludarabine
keywords: Allogeneic stem cell transplantation; intravenous busulfan; reduced toxicity conditioning