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- W1971482746 abstract "There is a need to improve the conditioning regimens for allogeneic HSCT, reducing the regimen related toxicity while maintaining the anti-leukemic effect. The combination of myeloablative doses of intravenous busulphan (BU) with fludarabine (F) has been utilized with an improved safety profile. We aimed to test the efficacy and safety of this combination (BUF), with a single daily dose of BU, since prior pharmacologic and clinical studies support its safety compared with standard 4-daily doses. Sixty seven consecutive adult patients undergoing HLA identical sibling allogeneic HSCT for myeloid malignancies were recruited from eight Spanish institutions. Their main characteristics are shown in table 1.Table 1Patients characteristicsPATIENTS67Age: median (range) years45 (17-74)Patients aged > 55 years30%Male gender58%DISEASEAML35 (52.2%)MDS Intermediate/High risk21 (31.3%)Secondary AML5 (7.5%)Myeloproliferative disorder6 (9%) Open table in a new tab Conditioning regimen consisted in BU, one daily IV infusion (3.2 mg/kg/d) for 4 days (total dose 12.8 mg/kg), combined with F, 40 mg/m2 daily (total dose 160 mg/m2). GVHD prophylaxis consisted in cyclosporine and methotrexate. Antimicrobial and other supportive measures were followed at each institution policies. Donor graft source was PB in 76% and BM in 24% of cases. Median CD34 cells infused were 4.0 mill/kg (0.6-17). All but one patient engrafted, with a median of 14 days (8-34) for 0.5 granulocytes and 12 days (7-46) for 20 platelets. Main toxicities (Bearman) were grade 1. Major toxicity was mucositis (Grade 2 or 3, 38% of cases). There were 3 grade-2 VOD cases (4.5%) which resolved. Acute GVHD grade 2-4 incidence was 22%. Day-100 accumulated mortality was 4.5%. The median follow-up of this ongoing study is 14 months (3-51). At the time of this interim analysis, the relapse free survival is 79.8% and overall survival 80.7%. Major causes of death were relapse (59%) and infection or toxicity (35%). In conclusion, in the HLA identical allogeneic HSCT setting BUF provides excellent tumour control and low transplant related toxicity and mortality. In particular, the incidence of VOD is < 5%." @default.
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- W1971482746 date "2011-02-01" @default.
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- W1971482746 title "Myeloablative Conditioning With Intravenous Busulphan in a Single Daily Dose and Fludarabine (BUF) for HLA-identical Sibling Allogeneic HSCT in Myeloid Malignancies" @default.
- W1971482746 doi "https://doi.org/10.1016/j.bbmt.2010.12.436" @default.
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