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Prepublished online as a Blood First Edition Paper on April 30, 2002; DOI 10.1182/blood-2002-02-0527. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-02-0527v1 100/4/1201    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Deeg, H. J. Articles by Appelbaum, F. R. Search for Related Content PubMed PubMed Citation Articles by Deeg, H. J. Articles by Appelbaum, F. R. Related Collections Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 August 2002, Vol. 100, No. 4, pp. 1201-1207 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Conditioning with targeted busulfan and cyclophosphamide for hemopoietic stem cell transplantation from related and unrelated donors in patients with myelodysplastic syndrome H. Joachim Deeg, Barry Storer, John T. Slattery, Claudio Anasetti, Kristine C. Doney, John A. Hansen, Hans-Peter Kiem, Paul J. Martin, Effie Petersdorf, Jerald P. Radich, Jean E. Sanders, Howard M. Shulman, Edus H. Warren, Robert P. Witherspoon, Eileen M. Bryant, Thomas R. Chauncey, Lisa Getzendaner, Rainer Storb, and Frederick R. Appelbaum From the Divisions of Clinical Research and Public Health Sciences, Fred Hutchinson Cancer Research Center; the Departments of Biostatistics, Medicine, Pathology, Pediatrics, and Pharmaceutics, University of Washington, and Veterans Administration Medical Center, Seattle, WA. A total of 109 patients (aged 6-66 years; median, 46 years) with myelodysplastic syndrome (MDS) were treated with busulfan (BU) targeted to plasma concentrations of 800 to 900 ng/mL plus cyclophosphamide (CY), 2 × 60 mg/kg, and hemopoietic stem cell (HSC) transplantation from related (n = 45) or unrelated donors (n = 64). At the time of transplantation, 69 patients had less than 5% myeloblasts in the marrow, and 40 patients had more advanced disease. All but 2 evaluable patients had engraftment. The Kaplan-Meier estimates of 3-year relapse-free survival (RFS) were 56% for related and 59% for unrelated recipients. The cumulative incidences of relapse were 16% for related and 11% for unrelated recipients. Nonrelapse mortality (NRM) at 100 days (3 years) was 12% (28%) for related and 13% (30%) for unrelated recipients. The only factor significant for RFS was the etiology of MDS (de novo better than treatment related; P = .03). Factors significantly correlated with relapse were advanced French-American-British classification (P = .002) and International Prognostic Scoring System score (P = .009), poor-risk cytogenetics (P = .03), and treatment-related etiology (P = .03). None of the factors examined was statistically significant for NRM. Patient age and donor type had no significant impact on outcome. RFS tended to be superior in patients receiving transplants with peripheral blood rather than marrow stem cells. Thus, a targeted BUCY regimen provided effective transplant conditioning for patients with MDS receiving transplants from HLA-identical siblings or alternative donors. Although there was still considerable nonrelapse morbidity and mortality, the present regimen was used successfully even in patients older than 60 years of age. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: H. J. Deeg Allogeneic Hematopoietic Cell Transplantation in Older Patients with Myelodysplastic Syndrome ASCO Educational Book, January 1, 2009; 2009(1): 420 - 424. [Abstract] [Full Text] [PDF] B. L. Scott, D. A. Wells, M. R. Loken, D. Myerson, W. M. Leisenring, and H. J. Deeg Validation of a flow cytometric scoring system as a prognostic indicator for posttransplantation outcome in patients with myelodysplastic syndrome Blood, October 1, 2008; 112(7): 2681 - 2686. [Abstract] [Full Text] [PDF] R. Marks, K. Potthoff, J. Hahn, G. Ihorst, H. Bertz, A. Spyridonidis, E. Holler, and J. M. 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