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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2010-3-15
pubmed:abstractText
A combination of fludarabine (Flu) and daily i.v. busulfan (Bu) is well tolerated and effective in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for acute myelogenous leukemia (AML). The addition of rabbit antithymocyte globulin (ATG) may reduce morbidity and mortality from graft-versus-host disease (GVHD), but lead to increased relapse. To compensate for this effect, we added 400 cGy of total body irradiation (TBI) to the Flu/Bu regimen in 89 patients, and compared outcomes with those achieved in 90 patients who received the drug combination alone. Although nonrelapse mortality (NRM) at 3 years did not differ between the groups, the inclusion of TBI significantly reduced relapse (hazard ratio [HR] = 0.29; 95% confidence interval [CI] = 0.15-0.54; P = .0001). Consequently, both overall survival (OS; HR = 0.50; 95% CI = 0.3-0.84; P = .009) and disease-free survival (DFS; HR = 0.43; 95% CI = 0.26-0.72; P = .001) were improved with the inclusion of TBI. This study confirms the importance of regimen intensity in allogeneic HSCT for AML. The combination of daily i.v. Bu, Flu, 400 cGy TBI, and ATG provides a well-tolerated regimen with antileukemic activity in AML comparable to that of other, conventional myeloablative (MA) regimens.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
1523-6536
pubmed:author
pubmed:copyrightInfo
Copyright (c) 2010 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
pubmed:issnType
Electronic
pubmed:volume
16
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
509-14
pubmed:meshHeading
pubmed-meshheading:19948235-Adolescent, pubmed-meshheading:19948235-Adult, pubmed-meshheading:19948235-Aged, pubmed-meshheading:19948235-Animals, pubmed-meshheading:19948235-Antilymphocyte Serum, pubmed-meshheading:19948235-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:19948235-Busulfan, pubmed-meshheading:19948235-Combined Modality Therapy, pubmed-meshheading:19948235-Female, pubmed-meshheading:19948235-Graft vs Host Disease, pubmed-meshheading:19948235-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:19948235-Humans, pubmed-meshheading:19948235-Injections, Intravenous, pubmed-meshheading:19948235-Leukemia, Myeloid, Acute, pubmed-meshheading:19948235-Male, pubmed-meshheading:19948235-Middle Aged, pubmed-meshheading:19948235-Retrospective Studies, pubmed-meshheading:19948235-Treatment Outcome, pubmed-meshheading:19948235-Vidarabine, pubmed-meshheading:19948235-Whole-Body Irradiation, pubmed-meshheading:19948235-Young Adult
pubmed:year
2010
pubmed:articleTitle
The addition of 400 cGY total body irradiation to a regimen incorporating once-daily intravenous busulfan, fludarabine, and antithymocyte globulin reduces relapse without affecting nonrelapse mortality in acute myelogenous leukemia.
pubmed:affiliation
Department of Medicine and Oncology, Foothills Hospital and Tom Baker Cancer Centre, 1331 29th Street NW, Calgary, Alberta, Canada. jamesrus@cancerboard.ab.ca
pubmed:publicationType
Journal Article