Retrospective comparison of hematopoietic stem cell transplantation following reduced-intensity conditioning with fludarabine/low-dose melphalan plus 4 Gy TBI versus fludarabine/ busulfan plus 4 Gy TBI
Fludarabine with intravenous busulfan (6.4 mg/kg; FB2) and fludarabine with intermediate-dose melphalan (140 mg/m 2 ; FM140) are the most widely used reduced-intensity conditioning (RIC) regimens for allogeneic hematopoietic stem cell transplantation. FM140 generally has a lower relapse rate and hig...
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| Veröffentlicht in: | International journal of hematology 2022-02, Vol.115 (2), p.244-254 |
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| creator | Yamada, Yuta Ikegawa, Shuntaro Najima, Yuho Atsuta, Yuya Konuma, Ryosuke Adachi, Hiroto Wada, Atsushi Kishida, Yuya Konishi, Tatsuya Nagata, Akihito Kaito, Satoshi Nagata, Ryohei Noguchi, Yuma Marumo, Atsushi Mukae, Junichi Inamoto, Kyoko Toya, Takashi Igarashi, Aiko Kobayashi, Takeshi Sakamaki, Hisashi Ohashi, Kazuteru Doki, Noriko |
| description | Fludarabine with intravenous busulfan (6.4 mg/kg; FB2) and fludarabine with intermediate-dose melphalan (140 mg/m
2
; FM140) are the most widely used reduced-intensity conditioning (RIC) regimens for allogeneic hematopoietic stem cell transplantation. FM140 generally has a lower relapse rate and higher non-relapse mortality (NRM), resulting in overall survival (OS) comparable to that seen with FB2. To evaluate the effect of reducing the melphalan dose, we retrospectively compared transplant outcomes in 156 patients who received FB2 (
n
= 103) or FM80 (
n
= 53) at our center (median age: 63 years; range 27–72 years). All patients received 4-Gy total body irradiation. Three-year OS, the cumulative incidence of relapse, and NRM were comparable between groups (FB2 vs. FM80, 58% vs. 47%,
p
= 0.24; 30% vs. 36%,
p
= 0.57; 17% vs. 21%,
p
= 0.44, respectively). There was no significant difference in the cumulative incidence of graft-versus-host disease (GVHD) at day 100, chronic GVHD at 3 years, or the 3-year GVHD-free/relapse-free survival rate. In the high-risk disease group, patients receiving FM80 tended to have lower 3-year OS (FB2 vs. FM80, 48% vs. 17%,
p
= 0.06). In summary, transplant outcomes following FB2 or FM80 were comparable except in patients with high-risk disease. |
| doi_str_mv | 10.1007/s12185-021-03233-4 |
| format | Article |
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2
; FM140) are the most widely used reduced-intensity conditioning (RIC) regimens for allogeneic hematopoietic stem cell transplantation. FM140 generally has a lower relapse rate and higher non-relapse mortality (NRM), resulting in overall survival (OS) comparable to that seen with FB2. To evaluate the effect of reducing the melphalan dose, we retrospectively compared transplant outcomes in 156 patients who received FB2 (
n
= 103) or FM80 (
n
= 53) at our center (median age: 63 years; range 27–72 years). All patients received 4-Gy total body irradiation. Three-year OS, the cumulative incidence of relapse, and NRM were comparable between groups (FB2 vs. FM80, 58% vs. 47%,
p
= 0.24; 30% vs. 36%,
p
= 0.57; 17% vs. 21%,
p
= 0.44, respectively). There was no significant difference in the cumulative incidence of graft-versus-host disease (GVHD) at day 100, chronic GVHD at 3 years, or the 3-year GVHD-free/relapse-free survival rate. In the high-risk disease group, patients receiving FM80 tended to have lower 3-year OS (FB2 vs. FM80, 48% vs. 17%,
p
= 0.06). In summary, transplant outcomes following FB2 or FM80 were comparable except in patients with high-risk disease.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/s12185-021-03233-4</identifier><identifier>PMID: 34652634</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Adult ; Aged ; Antineoplastic Agents - therapeutic use ; Busulfan ; Busulfan - therapeutic use ; Conditioning ; Female ; Fludarabine ; Graft versus host disease ; Graft vs Host Disease - etiology ; Graft vs Host Disease - prevention & control ; Graft-versus-host reaction ; Health risks ; Hematology ; Hematopoietic Stem Cell Transplantation - methods ; Hematopoietic stem cells ; Humans ; Intravenous administration ; Irradiation ; Male ; Medicine ; Medicine & Public Health ; Melphalan ; Melphalan - therapeutic use ; Middle Aged ; Myeloablative Agonists - therapeutic use ; Oncology ; Original Article ; Radiation ; Retrospective Studies ; Stem cell transplantation ; Stem cells ; Survival ; Survival Analysis ; Transplantation ; Transplantation Conditioning - methods ; Transplantation, Homologous ; Vidarabine - analogs & derivatives ; Vidarabine - therapeutic use ; Whole-Body Irradiation</subject><ispartof>International journal of hematology, 2022-02, Vol.115 (2), p.244-254</ispartof><rights>Japanese Society of Hematology 2021</rights><rights>2021. Japanese Society of Hematology.</rights><rights>Japanese Society of Hematology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c350t-528e4b8451ae1126efd68cd8fd5bc00dc0066a2d7ac3b45e19649892a49213f3</cites><orcidid>0000-0001-8910-0021</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12185-021-03233-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12185-021-03233-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34652634$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamada, Yuta</creatorcontrib><creatorcontrib>Ikegawa, Shuntaro</creatorcontrib><creatorcontrib>Najima, Yuho</creatorcontrib><creatorcontrib>Atsuta, Yuya</creatorcontrib><creatorcontrib>Konuma, Ryosuke</creatorcontrib><creatorcontrib>Adachi, Hiroto</creatorcontrib><creatorcontrib>Wada, Atsushi</creatorcontrib><creatorcontrib>Kishida, Yuya</creatorcontrib><creatorcontrib>Konishi, Tatsuya</creatorcontrib><creatorcontrib>Nagata, Akihito</creatorcontrib><creatorcontrib>Kaito, Satoshi</creatorcontrib><creatorcontrib>Nagata, Ryohei</creatorcontrib><creatorcontrib>Noguchi, Yuma</creatorcontrib><creatorcontrib>Marumo, Atsushi</creatorcontrib><creatorcontrib>Mukae, Junichi</creatorcontrib><creatorcontrib>Inamoto, Kyoko</creatorcontrib><creatorcontrib>Toya, Takashi</creatorcontrib><creatorcontrib>Igarashi, Aiko</creatorcontrib><creatorcontrib>Kobayashi, Takeshi</creatorcontrib><creatorcontrib>Sakamaki, Hisashi</creatorcontrib><creatorcontrib>Ohashi, Kazuteru</creatorcontrib><creatorcontrib>Doki, Noriko</creatorcontrib><title>Retrospective comparison of hematopoietic stem cell transplantation following reduced-intensity conditioning with fludarabine/low-dose melphalan plus 4 Gy TBI versus fludarabine/ busulfan plus 4 Gy TBI</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><addtitle>Int J Hematol</addtitle><description>Fludarabine with intravenous busulfan (6.4 mg/kg; FB2) and fludarabine with intermediate-dose melphalan (140 mg/m
2
; FM140) are the most widely used reduced-intensity conditioning (RIC) regimens for allogeneic hematopoietic stem cell transplantation. FM140 generally has a lower relapse rate and higher non-relapse mortality (NRM), resulting in overall survival (OS) comparable to that seen with FB2. To evaluate the effect of reducing the melphalan dose, we retrospectively compared transplant outcomes in 156 patients who received FB2 (
n
= 103) or FM80 (
n
= 53) at our center (median age: 63 years; range 27–72 years). All patients received 4-Gy total body irradiation. Three-year OS, the cumulative incidence of relapse, and NRM were comparable between groups (FB2 vs. FM80, 58% vs. 47%,
p
= 0.24; 30% vs. 36%,
p
= 0.57; 17% vs. 21%,
p
= 0.44, respectively). There was no significant difference in the cumulative incidence of graft-versus-host disease (GVHD) at day 100, chronic GVHD at 3 years, or the 3-year GVHD-free/relapse-free survival rate. In the high-risk disease group, patients receiving FM80 tended to have lower 3-year OS (FB2 vs. FM80, 48% vs. 17%,
p
= 0.06). In summary, transplant outcomes following FB2 or FM80 were comparable except in patients with high-risk disease.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Busulfan</subject><subject>Busulfan - therapeutic use</subject><subject>Conditioning</subject><subject>Female</subject><subject>Fludarabine</subject><subject>Graft versus host disease</subject><subject>Graft vs Host Disease - etiology</subject><subject>Graft vs Host Disease - prevention & control</subject><subject>Graft-versus-host reaction</subject><subject>Health risks</subject><subject>Hematology</subject><subject>Hematopoietic Stem Cell Transplantation - methods</subject><subject>Hematopoietic stem cells</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Irradiation</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melphalan</subject><subject>Melphalan - therapeutic use</subject><subject>Middle Aged</subject><subject>Myeloablative Agonists - therapeutic use</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Radiation</subject><subject>Retrospective Studies</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Transplantation</subject><subject>Transplantation Conditioning - methods</subject><subject>Transplantation, Homologous</subject><subject>Vidarabine - analogs & derivatives</subject><subject>Vidarabine - therapeutic use</subject><subject>Whole-Body Irradiation</subject><issn>0925-5710</issn><issn>1865-3774</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1qFTEYhgex2GP1BlxIwI2bsfmdn6UWrYWCIGcfMsk3PSmZZEwyLeduvBa33pQZT7VFoYsQyPe8b0KeqnpF8DuCcXuaCCWdqDElNWaUsZo_qTaka0TN2pY_rTa4p6IWLcHH1fOUrjEmLebts-qY8UbQhvFN9fMr5BjSDDrbG0A6TLOKNgWPwoh2MKkc5mAhW41ShglpcA7lqHyanfJZZVvQMTgXbq2_QhHMosHU1mfwyeZ9afTGrtQ6vrV5h0a3GBXVYD2cllhtQgI0gZt3qlSi2S0J8R_fz_do--EC3UBM5eBhCA1LWtz4H_uiOhqVS_Dybj-ptp8-bs8-15dfzi_O3l_Wmgmca0E74EPHBVFACG1gNE2nTTcaMWiMTVlNo6hplWYDF0D6hvddTxXvKWEjO6neHmrnGL4tkLKcbFr_RXkIS5JUdLTDHaO8oG_-Qa_DEn15nKQNbTHumVgpeqB0MZEijHKOdlJxLwmWq2l5MC2LafnbtFxDr--ql2EC8zfyR20B2AFIZeSvIN7f_UjtL3fguhY</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Yamada, Yuta</creator><creator>Ikegawa, Shuntaro</creator><creator>Najima, Yuho</creator><creator>Atsuta, Yuya</creator><creator>Konuma, Ryosuke</creator><creator>Adachi, Hiroto</creator><creator>Wada, Atsushi</creator><creator>Kishida, Yuya</creator><creator>Konishi, Tatsuya</creator><creator>Nagata, Akihito</creator><creator>Kaito, Satoshi</creator><creator>Nagata, Ryohei</creator><creator>Noguchi, Yuma</creator><creator>Marumo, Atsushi</creator><creator>Mukae, Junichi</creator><creator>Inamoto, Kyoko</creator><creator>Toya, Takashi</creator><creator>Igarashi, Aiko</creator><creator>Kobayashi, Takeshi</creator><creator>Sakamaki, Hisashi</creator><creator>Ohashi, Kazuteru</creator><creator>Doki, Noriko</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8910-0021</orcidid></search><sort><creationdate>20220201</creationdate><title>Retrospective comparison of hematopoietic stem cell transplantation following reduced-intensity conditioning with fludarabine/low-dose melphalan plus 4 Gy TBI versus fludarabine/ busulfan plus 4 Gy TBI</title><author>Yamada, Yuta ; Ikegawa, Shuntaro ; Najima, Yuho ; Atsuta, Yuya ; Konuma, Ryosuke ; Adachi, Hiroto ; Wada, Atsushi ; Kishida, Yuya ; Konishi, Tatsuya ; Nagata, Akihito ; Kaito, Satoshi ; Nagata, Ryohei ; Noguchi, Yuma ; Marumo, Atsushi ; Mukae, Junichi ; Inamoto, Kyoko ; Toya, Takashi ; Igarashi, Aiko ; Kobayashi, Takeshi ; Sakamaki, Hisashi ; Ohashi, Kazuteru ; Doki, Noriko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c350t-528e4b8451ae1126efd68cd8fd5bc00dc0066a2d7ac3b45e19649892a49213f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Busulfan</topic><topic>Busulfan - therapeutic use</topic><topic>Conditioning</topic><topic>Female</topic><topic>Fludarabine</topic><topic>Graft versus host disease</topic><topic>Graft vs Host Disease - etiology</topic><topic>Graft vs Host Disease - prevention & control</topic><topic>Graft-versus-host reaction</topic><topic>Health risks</topic><topic>Hematology</topic><topic>Hematopoietic Stem Cell Transplantation - methods</topic><topic>Hematopoietic stem cells</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Irradiation</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melphalan</topic><topic>Melphalan - therapeutic use</topic><topic>Middle Aged</topic><topic>Myeloablative Agonists - therapeutic use</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Radiation</topic><topic>Retrospective Studies</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Transplantation</topic><topic>Transplantation Conditioning - 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Academic</collection><jtitle>International journal of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamada, Yuta</au><au>Ikegawa, Shuntaro</au><au>Najima, Yuho</au><au>Atsuta, Yuya</au><au>Konuma, Ryosuke</au><au>Adachi, Hiroto</au><au>Wada, Atsushi</au><au>Kishida, Yuya</au><au>Konishi, Tatsuya</au><au>Nagata, Akihito</au><au>Kaito, Satoshi</au><au>Nagata, Ryohei</au><au>Noguchi, Yuma</au><au>Marumo, Atsushi</au><au>Mukae, Junichi</au><au>Inamoto, Kyoko</au><au>Toya, Takashi</au><au>Igarashi, Aiko</au><au>Kobayashi, Takeshi</au><au>Sakamaki, Hisashi</au><au>Ohashi, Kazuteru</au><au>Doki, Noriko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retrospective comparison of hematopoietic stem cell transplantation following reduced-intensity conditioning with fludarabine/low-dose melphalan plus 4 Gy TBI versus fludarabine/ busulfan plus 4 Gy TBI</atitle><jtitle>International journal of hematology</jtitle><stitle>Int J Hematol</stitle><addtitle>Int J Hematol</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>115</volume><issue>2</issue><spage>244</spage><epage>254</epage><pages>244-254</pages><issn>0925-5710</issn><eissn>1865-3774</eissn><abstract>Fludarabine with intravenous busulfan (6.4 mg/kg; FB2) and fludarabine with intermediate-dose melphalan (140 mg/m
2
; FM140) are the most widely used reduced-intensity conditioning (RIC) regimens for allogeneic hematopoietic stem cell transplantation. FM140 generally has a lower relapse rate and higher non-relapse mortality (NRM), resulting in overall survival (OS) comparable to that seen with FB2. To evaluate the effect of reducing the melphalan dose, we retrospectively compared transplant outcomes in 156 patients who received FB2 (
n
= 103) or FM80 (
n
= 53) at our center (median age: 63 years; range 27–72 years). All patients received 4-Gy total body irradiation. Three-year OS, the cumulative incidence of relapse, and NRM were comparable between groups (FB2 vs. FM80, 58% vs. 47%,
p
= 0.24; 30% vs. 36%,
p
= 0.57; 17% vs. 21%,
p
= 0.44, respectively). There was no significant difference in the cumulative incidence of graft-versus-host disease (GVHD) at day 100, chronic GVHD at 3 years, or the 3-year GVHD-free/relapse-free survival rate. In the high-risk disease group, patients receiving FM80 tended to have lower 3-year OS (FB2 vs. FM80, 48% vs. 17%,
p
= 0.06). In summary, transplant outcomes following FB2 or FM80 were comparable except in patients with high-risk disease.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>34652634</pmid><doi>10.1007/s12185-021-03233-4</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-8910-0021</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0925-5710 |
| ispartof | International journal of hematology, 2022-02, Vol.115 (2), p.244-254 |
| issn | 0925-5710 1865-3774 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2582808324 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Aged Antineoplastic Agents - therapeutic use Busulfan Busulfan - therapeutic use Conditioning Female Fludarabine Graft versus host disease Graft vs Host Disease - etiology Graft vs Host Disease - prevention & control Graft-versus-host reaction Health risks Hematology Hematopoietic Stem Cell Transplantation - methods Hematopoietic stem cells Humans Intravenous administration Irradiation Male Medicine Medicine & Public Health Melphalan Melphalan - therapeutic use Middle Aged Myeloablative Agonists - therapeutic use Oncology Original Article Radiation Retrospective Studies Stem cell transplantation Stem cells Survival Survival Analysis Transplantation Transplantation Conditioning - methods Transplantation, Homologous Vidarabine - analogs & derivatives Vidarabine - therapeutic use Whole-Body Irradiation |
| title | Retrospective comparison of hematopoietic stem cell transplantation following reduced-intensity conditioning with fludarabine/low-dose melphalan plus 4 Gy TBI versus fludarabine/ busulfan plus 4 Gy TBI |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T06%3A41%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Retrospective%20comparison%20of%20hematopoietic%20stem%20cell%20transplantation%20following%20reduced-intensity%20conditioning%20with%20fludarabine/low-dose%20melphalan%20plus%204%C2%A0Gy%20TBI%20versus%20fludarabine/%20busulfan%20plus%204%C2%A0Gy%20TBI&rft.jtitle=International%20journal%20of%20hematology&rft.au=Yamada,%20Yuta&rft.date=2022-02-01&rft.volume=115&rft.issue=2&rft.spage=244&rft.epage=254&rft.pages=244-254&rft.issn=0925-5710&rft.eissn=1865-3774&rft_id=info:doi/10.1007/s12185-021-03233-4&rft_dat=%3Cproquest_cross%3E2627009354%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2627009354&rft_id=info:pmid/34652634&rfr_iscdi=true |