1. Unrelated-donor bone marrow transplantation with a conditioning regimen including fludarabine, busulfan, and 4 Gy total body irradiation.
- Author
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Onishi, Yasushi, Mori, Shin-ichiro, Kusumoto, Shigeru, Sugimoto, Kyoko, Akahane, Daigo, Morita-Hoshi, Yuriko, Kim, Sung-Won, Fukuda, Takahiro, Heike, Yuji, Tanosaki, Ryuji, Tobinai, Kensei, and Takaue, Yoichi
- Subjects
IMMUNOSUPPRESSIVE agents ,THERAPEUTIC use of antimetabolites ,BUSULFAN ,ANTIMETABOLITES ,ANTIVIRAL agents ,BONE marrow transplantation ,GRAFT versus host disease ,GRAFT versus host reaction ,HEMATOPOIETIC stem cell transplantation ,HOMOGRAFTS ,IMMUNOSUPPRESSION ,RADIOTHERAPY ,RETROSPECTIVE studies ,KAPLAN-Meier estimator ,THERAPEUTICS - Abstract
We investigated the feasibility of reduced-intensity conditioning with 4 Gy total body irradiation, fludarabine (30 mg/m2 for 6 days), and busulfan (4 mg/kg for 2 days) for bone marrow transplantation from a serologically HLA-matched unrelated donor. Seventeen adult patients (median age, 55 years; range, 27-67 years) with various hematologic malignancies (6 in remission, 11 not in remission) were treated. Successful engraftment was achieved in all patients at a median of day 18 (range, day 14-35) after transplantation, although subsequent secondary graft failure was observed in 2 patients. The cumulative incidence of acute graft-versus-host disease (GVHD) of grades II to IV at day 100 was 48%. With a median follow-up of 286 days (range, 56-687 days), the rates of 1-year overall survival, 100-day nonrelapse mortality, and 1-year nonrelapse mortality were 41%, 14%, and 46%, respectively. Eleven patients died, and the causes of death were relapse (n = 4), pulmonary complications (n = 4), acute GVHD (n = 2), and sepsis (n = 1). The remaining 6 patients (at transplantation, 2 were in remission, and 4 were not in remission) are currently still in remission. These results suggest that this regimen reduces the risk of graft failure, but further studies are needed to ameliorate transplantation-related toxicities, primarily GVHD and/or pulmonary complications. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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