Long-term results of allogeneic hematopoietic stem cell
transplantation after reduced-intensity conditioning with
busulfan, fludarabine, and antithymocyte globulin

J 2011

Long-term results of allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin

KREJČÍ, Marta, Yvona BRYCHTOVÁ, Michael DOUBEK, Miroslav TOMIŠKA, Milan NAVRÁTIL et. al.

Basic information

Original name

Long-term results of allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin

Authors

KREJČÍ, Marta (203 Czech Republic, guarantor, belonging to the institution), Yvona BRYCHTOVÁ (203 Czech Republic), Michael DOUBEK (203 Czech Republic, belonging to the institution), Miroslav TOMIŠKA (203 Czech Republic, belonging to the institution), Milan NAVRÁTIL (203 Czech Republic, belonging to the institution), Zdeněk RÁČIL (203 Czech Republic, belonging to the institution), Dana DVOŘÁKOVÁ (203 Czech Republic, belonging to the institution), Ondřej HORKÝ (203 Czech Republic, belonging to the institution), Martina LENGEROVÁ (203 Czech Republic, belonging to the institution), Šárka POSPÍŠILOVÁ (203 Czech Republic, belonging to the institution) and Jiří MAYER (203 Czech Republic, belonging to the institution)

Edition

Neoplasma, 2011, 0028-2685

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Slovakia

Confidentiality degree

is not subject to a state or trade secret

Impact factor

Impact factor: 1.440

RIV identification code

RIV/00216224:14110/11:00054666

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.4149/neo_2011_05_406

UT WoS

000295309700007

Keywords in English

reduced-intensity conditioning; fludarabine; busulfan; antithymocyte globulin

Abstract

V originále

Reduced-intensity conditioning (RIG) is widely used for allogeneic stem cell transplantation (SCT). Here we present our long-term experience with RIG regimen consisting of fludarabine (30 mg/m(2)/day on days -10 to -5), busulfan (4mg/kg/day on days -6 and -5) and antithymocyte globulin (ATG Fresenius, 10 mg/kg/day on days -4 to -1) (Flu-Bu-ATG) in a cohort of 71 patients with various hematological malignancies including chronic myeloid leukemia (24 patients), acute myeloid leukemia (19 patients), lymphoma (20 patients), multiple myeloma (3 patients), myelodysplastic syndrome (3 patients), and myelofibrosis (2 patients). The median age was 50 years. The overall response rate was 87%, including 83% CR and 4% PR. The incidence of acute and chronic GVHD was 35% and 52% and the cumulative incidence of non-relapse mortality at 1 year and 4 years was 8% and 14%. With the median follow-up of 55.0 months, the 2- and 4-year event-free survival (EFS) was 49.0% and 40.3%, and the overall survival (OS) was 73.2% and 62.6%, respectively. Gender, age at SCT, type of donor, disease status at SCT, previous autologous transplantation, and complete chimerism by day +100 did not significantly influence EFS and OS. In a multivariate analysis, no presence of chronic GVHD (p=0.029, HR: 2.5),and diagnosis other than CML (p=0.018, HR: 4.6), and CD34+ dose < 5x10(6)/kg (p=0.010, HR: 2.8) were significant predictors of poor OS. Flu-Bu-ATG protocol is a RIG regimen that combines effective disease control with low non-relapse mortality and acceptable toxicity profile.

Links

MSM0021622430, plan (intention)

Name: Funkční a molekulární charakteristiky nádorových a normálních kmenových buněk - identifikace cílů pro nová terapeutika a terapeutické strategie

Investor: Ministry of Education, Youth and Sports of the CR, Functional and molecular characteristics of cancer and normal stem cells - identification of targets for novel therapeutics and therapeutic strategies

Cite

KREJČÍ, Marta, Yvona BRYCHTOVÁ, Michael DOUBEK, Miroslav TOMIŠKA, Milan NAVRÁTIL, Zdeněk RÁČIL, Dana DVOŘÁKOVÁ, Ondřej HORKÝ, Martina LENGEROVÁ, Šárka POSPÍŠILOVÁ and Jiří MAYER. Long-term results of allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin. Neoplasma. 2011, vol. 58, No 5, p. 406-414. ISSN 0028-2685. Available from: https://dx.doi.org/10.4149/neo_2011_05_406.

@article{964453,
   author = {Krejčí, Marta and Brychtová, Yvona and Doubek, Michael and Tomiška, Miroslav and Navrátil, Milan and Ráčil, Zdeněk and Dvořáková, Dana and Horký, Ondřej and Lengerová, Martina and Pospíšilová, Šárka and Mayer, Jiří},
   article_number = {5},
   doi = {http://dx.doi.org/10.4149/neo_2011_05_406},
   keywords = {reduced-intensity conditioning; fludarabine; busulfan; antithymocyte globulin},
   language = {eng},
   issn = {0028-2685},
   journal = {Neoplasma},
   title = {Long-term results of allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin},
   volume = {58},
   year = {2011}
}

TY  - JOUR
ID  - 964453
AU  - Krejčí, Marta - Brychtová, Yvona - Doubek, Michael - Tomiška, Miroslav - Navrátil, Milan - Ráčil, Zdeněk - Dvořáková, Dana - Horký, Ondřej - Lengerová, Martina - Pospíšilová, Šárka - Mayer, Jiří
PY  - 2011
TI  - Long-term results of allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin
JF  - Neoplasma
VL  - 58
IS  - 5
SP  - 406-414
EP  - 406-414
SN  - 00282685
KW  - reduced-intensity conditioning
KW  - fludarabine
KW  - busulfan
KW  - antithymocyte globulin
N2  - Reduced-intensity conditioning (RIG) is widely used for allogeneic stem cell transplantation (SCT). Here we present our long-term experience with RIG regimen consisting of fludarabine (30 mg/m(2)/day on days -10 to -5), busulfan (4mg/kg/day on days -6 and -5) and antithymocyte globulin (ATG Fresenius, 10 mg/kg/day on days -4 to -1) (Flu-Bu-ATG) in a cohort of 71 patients with various hematological malignancies including chronic myeloid leukemia (24 patients), acute myeloid leukemia (19 patients), lymphoma (20 patients), multiple myeloma (3 patients), myelodysplastic syndrome (3 patients), and myelofibrosis (2 patients). The median age was 50 years. The overall response rate was 87%, including 83% CR and 4% PR. The incidence of acute and chronic GVHD was 35% and 52% and the cumulative incidence of non-relapse mortality at 1 year and 4 years was 8% and 14%. With the median follow-up of 55.0 months, the 2- and 4-year event-free survival (EFS) was 49.0% and 40.3%, and the overall survival (OS) was 73.2% and 62.6%, respectively. Gender, age at SCT, type of donor, disease status at SCT, previous autologous transplantation, and complete chimerism by day +100 did not significantly influence EFS and OS. In a multivariate analysis, no presence of chronic GVHD (p=0.029, HR: 2.5),and diagnosis other than CML (p=0.018, HR: 4.6), and CD34+ dose < 5x10(6)/kg (p=0.010, HR: 2.8) were significant predictors of poor OS. Flu-Bu-ATG protocol is a RIG regimen that combines effective disease control with low non-relapse mortality and acceptable toxicity profile.
ER  -

KREJČÍ, Marta, Yvona BRYCHTOVÁ, Michael DOUBEK, Miroslav TOMIŠKA, Milan NAVRÁTIL, Zdeněk RÁČIL, Dana DVOŘÁKOVÁ, Ondřej HORKÝ, Martina LENGEROVÁ, Šárka POSPÍŠILOVÁ and Jiří MAYER. Long-term results of allogeneic hematopoietic stem cell transplantation after reduced-intensity conditioning with busulfan, fludarabine, and antithymocyte globulin. \textit{Neoplasma}. 2011, vol.~58, No~5, p.~406-414. ISSN~0028-2685. Available from: https://dx.doi.org/10.4149/neo\_{}2011\_{}05\_{}406.

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