Comparison of Cyclophosphamide Combined with Total Body Irradiation, Oral Busulfan, or Intravenous Busulfan for Allogeneic Hematopoietic Cell Transplantation in Adults with Acute Lymphoblastic Leukemia

作者：Mitsuhashi Kenjiro^*; Kako Shinichi; Shigematsu Akio; Atsuta Yoshiko; Doki Noriko; Fukuda Takahiro; Kanamori Heiwa; Onizuka Makoto; Takahashi Satoshi; Ozawa Yukiyasu; Kurokawa Mineo; Inoue Yoshiko; Nagamura Inoue Tokiko; Morishima Yasuo; Mizuta Shuichi; Tanaka Junji

来源：Biology of Blood and Marrow Transplantation, 2016, 22(12): 2194-2200.

DOI：10.1016/j.bbmt.2016.09.007

• Acute lymphoblastic leukemia
• Allogeneic hematopoietic cell transplantation
• Total body irradiation
• Busulfan

We conducted a retrospective analysis to compare outcomes in adult patients with acute lymphoblastic leukemia (ALL) who underwent allogeneic hematopoietic cell transplantation (allo-HCT) with conditioning regimens containing cyclophosphamide (CY) in combination with total body irradiation (TBI), oral busulfan (p.o. BU), or intravenous busulfan (i.v. BU). We used data for January 2000 to December 2012 from the Transplant Registry Unified Management Program of the Japan Society of Hematopoietic Cell Transplantation. We identified 2130 patients treated with TBI/CY (n = 2028), p.o. BU/CY (n = 60), or i.v. BU/CY (n = 42). Two-year overall survival (OS) and 2-year relapse-free survival rates were 69.0% and 62.1%, respectively, in the TBI/CY group, 55.9% and 54.2% in the p.o. BU/CY group, and 71.0% and 46.8% in the i.v. BU/CY group. In multivariate analysis, compared with TBI/CY, p.o. BU/CY, but not i.v. BU/CY, was associated with lower OS (hazard ratio [HR], 1.46; P=.047) and a higher incidence of sinusoidal obstruction syndrome (HR, 3.36; P =.030). No between-group differences were seen in the incidence of nonrelapse mortality, relapse, acute graft-versus-host disease (GVHD), or chronic GVHD. We suggest that i.v. BU/CY might be a possible alternative allo-HCT conditioning regimen for adults with ALL who are not suitable for TBI.

• 出版日期2016-12
• 单位河北医科大学