Busulfan-cyclophosphamide vs fludarabine-busulfan for allogeneic transplant in acute myeloid leukemia.

IF 3 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2025-06-01 Epub Date: 2025-05-28 DOI:10.1080/14796694.2025.2507563

Ben Abdeljelil N, Kanoun R Y, Mekni S, Turki I, Ben Yaiche I, Ouerghi R, Belloumi D, Torjemane L, Ladeb S, Ben Othman T

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引用次数: 0

Abstract

Background: Busulfan and cyclophosphamide (BuCy) is the standard myeloablative conditioning regimen for patients with acute myeloblastic leukemia (AML) undergoing allogeneic hematopoietic stem-cell transplantation (allo-HSCT). Fludarabine and busulfan (FluBu) conditioning seems to have similar efficacy with less toxicity.

Aims and methods: Descriptive retrospective study conducted on patients with AML who underwent geno-identical allo-HSCT between January 2011 and December 2022. Patients received a myeloablative conditioning with either BuCy2 orFluBu4. The objective was to compare the efficacy and safety of this regimens.

Results: A total of 113 adult patients were included. Conditioning regimen was BuCy2 in 81% of patients (n = 92) and FluBu4 in 19% of patients (n = 21). The 3-year estimated overall survival and event-free survival were 65% vs 81% (p = 0.19) and 58% vs 76% (p = 0.18) in BuCy2 and FluBu4 regimens, respectively. GVHD-Relapse Free Survival was better in FluBu4 group compared to BuCy2 group (28% vs 41%, p = 0.03). The Cumulative incidence of relapse and non-relapse mortality were 38% vs 14% (p = 0.17) and 15% vs 10% (p = 0.57) in BuCy2 and FluBu4, respectively. Both regimens yield comparable toxicities.

Conclusion: Myeloablative FluBu4 conditioning appeared to achieve clinical outcomes similar to BuCy2 and may be considered as a possible alternative for patients at high risk of NRM.

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布磺胺-环磷酰胺vs氟达拉滨-布磺胺用于急性髓系白血病同种异体移植。

背景：布苏凡和环磷酰胺（BuCy）是急性髓母细胞白血病（AML）患者接受同种异体造血干细胞移植（alloo - hsct）的标准清髓调节方案。氟达拉滨和布硫凡（FluBu）调节似乎具有相似的疗效，毒性较小。目的和方法：对2011年1月至2022年12月间接受同种异体造血干细胞移植的AML患者进行描述性回顾性研究。患者接受BuCy2或flubu4的清髓治疗。目的是比较这两种治疗方案的有效性和安全性。结果：共纳入113例成人患者。81%的患者（n = 92）的调理方案为BuCy2, 19%的患者（n = 21）的调理方案为FluBu4。BuCy2和FluBu4方案的3年估计总生存率和无事件生存率分别为65%对81% （p = 0.19）和58%对76% （p = 0.18）。与BuCy2组相比，FluBu4组的gvhd无复发生存率更高（28% vs 41%, p = 0.03）。BuCy2和FluBu4的累积复发率和非复发死亡率分别为38%对14% （p = 0.17）和15%对10% （p = 0.57）。两种治疗方案的毒性相当。结论：清髓性FluBu4调节似乎达到了与BuCy2相似的临床结果，可能被认为是NRM高风险患者的可能替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.