Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia

被引：16

作者：

Kato, Motohiro ^{[1
,2
,3
]}

Takahashi, Yoshiyuki ^{[4
]}

Tomizawa, Daisuke ^{[5
]}

Okamoto, Yasuhiro ^{[6
]}

Inagaki, Jiro ^{[7
]}

Koh, Katsuyoshi ^{[3
]}

Ogawa, Atsushi ^{[8
]}

Okada, Keiko ^{[9
]}

Cho, Yuko ^{[10
]}

Takita, Junko ^{[1
,2
]}

Goto, Hiroaki ^{[11
]}

Sakamaki, Hisashi ^{[12
]}

Yabe, Hiromasa ^{[13
]}

Kawa, Keisei ^{[14
]}

Suzuki, Ritsuro ^{[15
]}

Kudo, Kazuko ^{[16
]}

Kato, Koji ^{[17
]}

机构：

[1] Univ Tokyo, Dept Cell Therapy & Transplantat Med, Tokyo, Japan

[2] Univ Tokyo, Dept Pediat, Tokyo, Japan

[3] Saitama Childrens Med Ctr, Dept Hematol Oncol, Saitama, Japan

[4] Nagoya Univ, Grad Sch Med, Dept Pediat, Nagoya, Aichi 4648601, Japan

[5] Tokyo Med & Dent Univ, Dept Pediat, Tokyo, Japan

[6] Kagoshima Univ, Dept Pediat, Kagoshima 890, Japan

[7] Kyushu Natl Canc Ctr, Dept Pediat, Fukuoka, Japan

[8] Niigata Canc Ctr Hosp, Dept Pediat, Niigata, Japan

[9] Osaka City Gen Hosp, Dept Pediat Hematol Oncol, Osaka, Japan

[10] Hokkaido Univ Hosp, Dept Pediat, Sappro, Japan

[11] Kanagawa Childrens Med Ctr, Div Hematooncol Regenerat Med, Yokohama, Kanagawa, Japan

[12] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Hematol, Tokyo, Japan

[13] Tokai Univ, Dept Cell Transplantat & Regenerat Med, Isehara, Kanagawa, Japan

[14] Japanese Red Cross Kinki Block Blood Ctr, Osaka, Japan

[15] Nagoya Univ, Dept HSCT Data Management & Biostat, Nagoya, Aichi 4648601, Japan

[16] Shizuoka Childrens Hosp, Div Hematol & Oncol, Shizuoka, Japan

[17] Japanese Red Cross Nagoya First Hosp, Childrens Med Ctr, Dept Hematol & Oncol, Nagoya, Aichi, Japan

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2013年 / 19卷 / 12期

关键词：

Acute leukemia; Children; Busulfan; BONE-MARROW-TRANSPLANTATION; TOTAL-BODY IRRADIATION; NON-HODGKIN-LYMPHOMA; MYELODYSPLASTIC SYNDROME; PREPARATIVE REGIMEN; DOSE ADJUSTMENT; CHILDREN; CYCLOPHOSPHAMIDE; PHARMACOKINETICS; TOXICITY;

D O I：

10.1016/j.bbmt.2013.09.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n = 198) or oral busulfan (oral-BU) (n = 262) myeloablative conditioning. OS at 3 years was 53.4% +/- 3.7% with iv-BU and 55.1% +/- 3.1% with oral-BU; the difference was not statistically significant (P = .77). OS at 3 years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4% +/- 5.5% with iv-BU and 54.6% +/- 4.1 with oral-BU (P = .51) and 51.0% +/- 5.0% with iv-BU and 55.8% +/- 4.8% with oral-BU (P = .83), respectively. Cumulative incidence of relapse at 3 years with iv-BU was similar to that with oral-BU (39.0% +/- 3.6% and 36.4% +/- 3.1%, respectively; P = .67). Cumulative incidence of NRM at 3 years was 16.6% +/- 2.7% with iv-BU and 18.3% +/- 2.5% with oral-BU (P = .51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia. (C) 2013 American Society for Blood and Marrow Transplantation.

引用

页码：1690 / 1694

页数：5

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