Fludarabine and busulfan as a reduced‑toxicity myeloablative conditioning regimen in allogeneic hematopoietic stem cell transplantation for acute leukemia patients

Dai,Zhiming; Liu,Jie; Zhang,Wang‑Gang; Cao,Xingmei; Zhang,Yang; Dai,Zhijun

doi:10.3892/mco.2016.765

Fludarabine and busulfan as a reduced‑toxicity myeloablative conditioning regimen in allogeneic hematopoietic stem cell transplantation for acute leukemia patients

Authors:
- Zhiming Dai
- Jie Liu
- Wang‑Gang Zhang
- Xingmei Cao
- Yang Zhang
- Zhijun Dai
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Affiliations: Department of Hematology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China, Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710004, P.R. China
Published online on: February 3, 2016 https://doi.org/10.3892/mco.2016.765
Pages: 667-671

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Abstract

The optimal conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo‑HSCT) in acute leukemia remains undefined. We evaluated the outcomes in 30 patients with acute leukemia who underwent allo‑HSCT from human leukocyte antigen‑matched donors after conditioning with busulfan and fludarabine (BuFlu). The regimen comprised injection of busulfan 3.2 mg̸kg daily on 4 consecutive days and fludarabine 30 mg̸m2 daily for 4 doses. All 30 patients achieved hematopoiesis reconstitution with full donor chimerism confirmed by short tandem repeat DNA analysis. The most common regimen‑related toxicity was mucositis (86.7%), followed by cytomegalovirus infection (80%). Serious regimen‑related toxicities were rare. Acute graft vs. host disease (aGVHD) was detected in 46.7% of the patients; 33.4% had grade I‑II aGVHD and 13.3% had grade III‑IV aGVHD. Chronic GVHD (cGVHD) was noted in 20% of the patients. The overall survival and disease‑free survival rates were 66.7 and 53%, respectively, with a median follow‑up of 25 months for surviving patients. Therefore, BuFlu was an effective conditioning regimen with a low rate of transplant‑related adverse effects and increased antileukemic effects in patients with acute leukemia undergoing allo‑HSCT.

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