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- Title
Intravenous BU plus Mel: an effective, chemotherapy-only transplant conditioning regimen in patients with ALL.
- Authors
Kebriaei, P; Madden, T; Wang, X; Thall, P F; Ledesma, C; de Lima, M; Shpall, E J; Hosing, C; Qazilbash, M; Popat, U; Alousi, A; Nieto, Y; Champlin, R E; Jones, R B; Andersson, B S
- Abstract
We investigated the administration of i.v. BU combined with melphalan (Mel) in patients with ALL undergoing allogeneic hematopoietic SCT. Forty-seven patients with a median age of 33 years (range 20-61) received a matched sibling (n=27) or matched unrelated donor transplant (n=20) for ALL in first CR (n=26), second CR (n=13), or with more advanced disease (n=8). BU was infused daily for 4 days, either at a fixed dose of 130 mg/m2 (5 patients) or using pharmacokinetic (PK) dose adjustment (42 patients), to target an average daily area-under-the-curve (AUC) of 5000 μmol/min, determined by a test dose of i.v. BU at 32 mg/m2. This was followed by a rest day, then two daily doses of Mel at 70 mg/m2. Stem cells were infused on the following day. The 2-year OS, PFS and non-relapse mortality (NRM) rates were 35% (95% confidence interval (CI), 23-51%), 31% (95% CI, 21-48%) and 37% (95% CI, 23-50%), respectively. Acute NRM at 100 days was favorable at 12% (95% CI, 5-24%); however, the 2-year NRM was significantly higher for patients older than 40 years, 58% vs 20%, mainly due to GVHD.
- Subjects
INTRAVENOUS therapy; LYMPHOBLASTIC leukemia; LEUKEMIA; CANCER chemotherapy; GRAFT versus host disease; HEMATOPOIETIC stem cell transplantation; ORGAN donors; PATIENTS
- Publication
Bone Marrow Transplantation, 2013, Vol 48, Issue 1, p26
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/bmt.2012.114