Comparative analysis of BU and CY versus CY and TBI in full intensity unrelated marrow donor transplantation for AML, CML and myelodysplasia

作者：Uberti J P^*; Agovi M A; Tarima S; Haagenson M; Gandham S; Anasetti C; Baker K S; Bolwell B J; Bornhauser M; Chan K W; Copelan E; Davies S M; Finke J; Hale G A; Kollman C; McCarthy P L; Ratanatharathorn V; Ringden O; Weisdorf D J; Rizzo J D

来源：Bone Marrow Transplantation, 2011, 46(1): 34-43.

DOI：10.1038/bmt.2010.81

• unrelated donor transplantation
• TBI conditioning regimens
• BU

We retrospectively compared clinical outcomes in 1593 T-replete unrelated donor (URD) marrow transplant recipients with AML, MDS and CML who received myeloablative conditioning regimens of either BU and CY (BuCy), standard-dose Cy/TBI (1000-1260 cGy) or high-dose Cy/TBI (1320-1500 cGy). Subjects were drawn from patients transplanted between 1991 and 1999 facilitated by the National Marrow Donor Program. Patients who received high-dose Cy/TBI regimens were slightly younger, more likely to receive a mismatched transplant and to have intermediate or advanced disease compared with patients in the BuCy or standard-dose TBI group. Neutrophil recovery was significantly higher in the standard-dose CY/TBI group compared with the high-dose Cy/TBI or BuCy group. Patients who received the high-dose Cy/TBI regimen had an increased risk of developing grades III-IV aGVHD when compared with the control group who received BuCy (P = 0.011). OS, disease-free survival (DFS), TRM and relapse were not significantly different between any of the regimens. We conclude that BuCy, standard-dose and high-dose Cy/TBI regimens have equivalent efficacy profiles for OS, DFS, TRM and relapse risk in patients undergoing T-replete URD marrow transplantation for AML, CML and MDS. Bone Marrow Transplantation (2011) 46, 34-43; doi:10.1038/bmt.2010.81; published online 19 April 2010

• 出版日期2011-1