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Conditioning Regimens

Single center retrospective analysis of BU-based conditioning regimens in allogeneic transplantation

Bone Marrow Transplantation volume 47, pages 181–189 (2012)Cite this article

Abstract

We performed a single institution retrospective analysis of 114 patients treated with BU-based pretransplant conditioning regimens. Oral BU was administered to 76 patients (total dose 16 mg/kg or 8 mg/kg) and i.v. BU to 38 others (total dose 12.8 mg/kg or 6.4 mg/kg). Either CY (n=74) or fludarabine (n=40) was given in combination with BU. Median age was 35 years in the oral BU group and 48.5 years with i.v. BU (P<0.001). OS and PFS rates at 3-years post HSCT were not different in patients who received either i.v. or oral BU (OS: 41.3 vs 44.0% (P=0.981); PFS: 52.7 vs 54.7% (P=0.526), respectively). The i.v. BU, however, was associated with a significantly shorter time to engraftment (13.5 days vs 16 days, respectively; P<0.001). There were no significant differences in survival or 100-day mortality for patients who received either CY or fludarabine, in combination with BU. After adjustment for confounders, multivariate analysis showed that age of transplant (P=0.002), donor type (sibling or unrelated; P=0.003), GVHD (P<0.05) and route of administration (P=0.023) were significant risk factors for OS. The i.v. BU used in an older age group yielded equivalent survival compared with oral BU used in a younger population.

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Acknowledgements

We are thankful to Dr John Rush for his invaluable comments and editorial assistance with the manuscript. We also gratefully acknowledge Zhang Xue Hui and Lee Jing Jing for their help in collating the database. We would also like to thank the support of our hematology pharmacists, nurses and medical colleagues. This work was supported by grant support from the Singapore Cancer Syndicate and the National Medical Research Council.

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Authors and Affiliations

  1. Duke NUS Graduate Medical School, Singapore, Republic of Singapore

    A M Wong, J C Allen & W Y K Hwang

  2. Department of Hematology, Singapore General Hospital, Singapore, Republic of Singapore

    Y T Goh, Y C Linn, S M Y Loh, C P Diong & W Y K Hwang

  3. Division of Research, Singapore General Hospital, Singapore, Republic of Singapore

    Y T Goh

  4. Division of Medical Sciences, Laboratory of Clinical Pharmacology, Humphrey Oei Institute of Cancer Research, National Cancer Centre Singapore, Singapore, Republic of Singapore

    B Chowbay

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  1. A M Wong
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  2. J C Allen
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Correspondence to W Y K Hwang.

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Wong, A., Allen, J., Goh, Y. et al. Single center retrospective analysis of BU-based conditioning regimens in allogeneic transplantation. Bone Marrow Transplant 47, 181–189 (2012). https://doi.org/10.1038/bmt.2011.43

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