Reduced‐toxicity conditioning regimen with busulfan, fludarabine, rATG, and 400 cGy TBI in pediatric patients undergoing hematopoietic stem cell transplant for high‐risk hematologic malignancies

Background Myeloablative conditioning regimens decrease the risk of relapse in pediatric patients undergoing allogeneic hematopoietic stem cell transplant (HCT) for hematologic malignancies, but cause significant toxicities Procedure This prospective study evaluated the use of a reduced‐toxicity, myeloablative regimen with dose‐adjusted busulfan, fludarabine, antithymocyte globulin and 400 cGy of total body irradiation in 40 patients 4000 μmol*min/day with two‐year relapse‐free survival approaching 80% Conclusions This conditioning regimen is safe and effective in patients with high‐risk leukemias, particularly myeloid disease. Larger studies are needed to compare its safety and efficacy to other myeloablative regimens in this population.