Allogeneic peripheral blood stem cell transplantation using a low toxicity conditioning regimen with fludarabine and busulfan for 13 patients with hematological malignancies

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Author:
ZHANG Yang(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
WANG Fong-xia(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
ZHANG Peng-yu(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
ZHANG Wang-gang(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
WANG Jian-li(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
HE Ai-li(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
CAO Xing-mei(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
CHEN Yin-xia(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
LIU Jie(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
YANG Yun,(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
MA Xiao-rong(Department of Hematology, Second Hospital Affiliated to Xi'an Jiaotong University Medical College, Xi'an 710004, China)
Journal Title:
Journal of Leukemia & Lymphoma
Issue:
Volume 21, Issue 06, 2012
DOI:
10.3760/cma.j.issn.1009-9921.2012.06.011
Key Word:
Hematologic neoplasms; Hematopoietic stem cell transplantation; Transplantation conditioning;Fludarabine

Abstract: [Objective]To discuss the clinical effect of fludarabine and busulfan (Bu+Flu) as a low toxicity myeloablative conditioning regimen for allogeneic peripheral blood stem cell transplantation (allo-HSCT) in leukemia patients.[Methods]Clinical data of 13 patients with hematological malignancies receiving conditioning regimen with Bu+Flu for allo-HSCT were analyzed retrospectively.Conditioning regimen was Bu+Flu,compalriot mismatched and unrelated transplantation combined with rabbit anti-human thymocytes immune globulin (ATG).CsA+short course of methotrexate or CsA + mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD).DNA sequencing of short tandem repeat (STR) polymorphism analysis method was performed for identification of donor stem cells implantation.[Results]13 patients all tolerated with this conditioning regimen well,no serious complications occurred.Neutrophil engraftment was at 9-15 days (median 11 days),platelet engraftment at 8-25 days (median 13 days).10 patients achieved hematopoiesis reconstitution with their full donor chimerisms confirmed by STR-DNA analysis.Acute GVHD occurred in 5 cases,accounting for 38.5%.Chronic GVHD occurred in 4 cases of 10 patients could be assessed,accounting for 40.0%.Severe GVHD more than Ⅱ degree did not happen.1-39 months (median time 11 months) of follow-up revealed the overall survival rate of 76.9%(10/13),disease-free survival of 61.5% (8/13).The causes for death were relapse in all.[Conclusion]The conditioning regimen with Bu+Flu has low toxicity,well tolerance and better effect.

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