Higher busulfan dose intensity appears to improve leukemia-free and overall survival in AML allografted in CR2: An analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation
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Higher busulfan dose intensity appears to improve leukemia-free and overall survival in AML allografted in CR2: An analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. / Kharfan-Dabaja, Mohamed A; Labopin, Myriam; Bazarbachi, Ali; Socie, Gerard; Kroeger, Nicolaus; Blaise, Didier; Veelken, Hendrik; Bermudez, Arancha; Or, Reuven; Lioure, Bruno; Beelen, Dietrich; Fegueux, Nathalie; Hamladji, Rose Marie; Nagler, Arnon; Mohty, Mohamad.
In: LEUKEMIA RES, Vol. 39, No. 9, 09.2015, p. 933-7.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Higher busulfan dose intensity appears to improve leukemia-free and overall survival in AML allografted in CR2: An analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation
AU - Kharfan-Dabaja, Mohamed A
AU - Labopin, Myriam
AU - Bazarbachi, Ali
AU - Socie, Gerard
AU - Kroeger, Nicolaus
AU - Blaise, Didier
AU - Veelken, Hendrik
AU - Bermudez, Arancha
AU - Or, Reuven
AU - Lioure, Bruno
AU - Beelen, Dietrich
AU - Fegueux, Nathalie
AU - Hamladji, Rose Marie
AU - Nagler, Arnon
AU - Mohty, Mohamad
N1 - Copyright © 2015 Elsevier Ltd. All rights reserved.
PY - 2015/9
Y1 - 2015/9
N2 - Allogeneic hematopoietic cell transplantation is a potentially curative treatment in patients with acute myeloid leukemia. Recent advances in the field of hematopoietic cell allografting have resulted in a practice shift, favoring less intense preparative regimens. We present results of a retrospective comparative analysis of two preparative regimens, namely FB2 (IV fludarabine plus IV busulfan 6.4mg/kg±10%) and FB4 (IV fludarabine plus IV busulfan 12.8mg/kg ±10%), in patients with acute myeloid leukemia undergoing hematopoietic cell allografting in second complete remission at EBMT participating centers. Between 2003 and 2010, 128 AML patients in second complete remission were allografted following a preparative regimen of FB2 (n=88) or FB4 (n=40). The median time-to-neutrophil engraftment was similar whether patients received FB2 (16 (5-38) days) or FB4 (16 (9-29) days), p=0.45. A multivariate analysis showed that use of FB4 resulted in improved 2-year leukemia-free (HR=0.44 (95%CI=0.21, 0.94), p=0.03) and overall survival (HR=0.38 (95%CI=0.16, 0.86), p=0.02). Cumulative incidence of non-relapse mortality (2-year) for all patients was 21% (95%CI=14-28%). Our analysis suggests that FB4 improves 2-year leukemia-free and overall survival in AML allografted in second complete remission. A confirmatory randomized controlled trial that compares these two preparative regimens (FB2 vs. FB4) in AML in CR2 is definitely warranted.
AB - Allogeneic hematopoietic cell transplantation is a potentially curative treatment in patients with acute myeloid leukemia. Recent advances in the field of hematopoietic cell allografting have resulted in a practice shift, favoring less intense preparative regimens. We present results of a retrospective comparative analysis of two preparative regimens, namely FB2 (IV fludarabine plus IV busulfan 6.4mg/kg±10%) and FB4 (IV fludarabine plus IV busulfan 12.8mg/kg ±10%), in patients with acute myeloid leukemia undergoing hematopoietic cell allografting in second complete remission at EBMT participating centers. Between 2003 and 2010, 128 AML patients in second complete remission were allografted following a preparative regimen of FB2 (n=88) or FB4 (n=40). The median time-to-neutrophil engraftment was similar whether patients received FB2 (16 (5-38) days) or FB4 (16 (9-29) days), p=0.45. A multivariate analysis showed that use of FB4 resulted in improved 2-year leukemia-free (HR=0.44 (95%CI=0.21, 0.94), p=0.03) and overall survival (HR=0.38 (95%CI=0.16, 0.86), p=0.02). Cumulative incidence of non-relapse mortality (2-year) for all patients was 21% (95%CI=14-28%). Our analysis suggests that FB4 improves 2-year leukemia-free and overall survival in AML allografted in second complete remission. A confirmatory randomized controlled trial that compares these two preparative regimens (FB2 vs. FB4) in AML in CR2 is definitely warranted.
KW - Adult
KW - Aged
KW - Antineoplastic Agents, Alkylating
KW - Busulfan
KW - Female
KW - Graft vs Host Disease
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Leukemia, Myeloid, Acute
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Randomized Controlled Trials as Topic
KW - Remission Induction
KW - Retrospective Studies
KW - Survival Analysis
KW - Transplantation Conditioning
KW - Transplantation, Homologous
KW - Vidarabine
U2 - 10.1016/j.leukres.2015.04.009
DO - 10.1016/j.leukres.2015.04.009
M3 - SCORING: Journal article
C2 - 26003666
VL - 39
SP - 933
EP - 937
JO - LEUKEMIA RES
JF - LEUKEMIA RES
SN - 0145-2126
IS - 9
ER -