Disminución de mortalidad en hemopatías malignas con un nuevo método de acondicionamiento para trasplante alogénico mieloablativo

Abstract

Introduction

Allogeneic stem cell transplantation (ASCT) is the ideal treatment for haematological malignancies. However, the morbidity and mortality associated with the procedure limit its use.

Objectives

To describe clinical characteristics, toxicity, and survival of adult Mexican patients undergoing ASCT using busulfan with a reduced dose of cyclophosphamide (BUCY 2) as a conditioning method.

Methods

A prospective cohort study was conducted from October 1999 to December 2014, by performing an analysis of clinical characteristics, complications, and survival of 35 patients using this conditioning regimen.

Results

The study included 35 patients undergoing ASCT with reduced BUCY 2. All of them had an HLA-matched related donor, with a median age of 33 years (range 16-49), and 60% were male. The patients had the following underlying diseases: myelodysplastic syndrome in 14 patients (40%), chronic myeloid leukaemia in 9 (25.7%), acute leukaemia in 10 (23.5%), and paroxysmal nocturnal haemoglobinuria in 2 (5.7%). The median of transfused CD34 + cells was 2.04 × 10⁶/kg. The median time to neutrophil and platelet recovery was 21 and 18 days, respectively. The most common toxicity was mucositis (91.4%). Transplant related mortality was 5.7%, and 5-year overall survival was 72.5%.

Conclusions

The conditioning method described earlier preserves a cytotoxic effect allowing eradication of the malignant clone, and achieving a graft with acceptable toxicity, and low transplant related mortality, representing a good alternative for ASCT.