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Blood, 1 August 2004, Vol. 104, No. 3, pp. 857-864. Prepublished online as a Blood First Edition Paper on April 8, 2004; DOI 10.1182/blood-2004-02-0414. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-02-0414v1 104/3/857    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 de Lima, M. Articles by Andersson, B. S. Search for Related Content PubMed PubMed Citation Articles by de Lima, M. Articles by Andersson, B. S. Related Collections Immunobiology Neoplasia Transplantation Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Once-daily intravenous busulfan and fludarabine: clinical and pharmacokinetic results of a myeloablative, reduced-toxicity conditioning regimen for allogeneic stem cell transplantation in AML and MDS Marcos de Lima, Daniel Couriel, Peter F. Thall, Xuemei Wang, Timothy Madden, Roy Jones, Elizabeth J. Shpall, Munir Shahjahan, Betty Pierre, Sergio Giralt, Martin Korbling, James A. Russell, Richard E. Champlin, and Borje S. Andersson From the Departments of Blood and Marrow Transplantation, Biostatistics and Applied Mathematics, and Pharmaceutical Development Center, University of Texas MD Anderson Cancer Center, Houston, TX; and the Alberta Bone Marrow Transplant Program, Calgary, AB, Canada. Postulating favorable antileukemic effect with improved safety, we used intravenous busulfan and fludarabine as conditioning therapy for allogeneic hematopoietic stem cell transplantation (HSCT) for acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). Fludarabine 40 mg/m2 and intravenous busulfan 130 mg/m2 were given once daily for 4 days, with tacrolimus-methotrexate as graft-versus-host disease (GVHD) prophylaxis. We treated 74 patients with AML and 22 patients with MDS; patients had a median age of 45 years (range, 19-66 years). Only 20% of the patients were in first complete remission (CR) at transplantation. Donors were HLA-compatible related (n = 60) or matched unrelated (n = 36). The CR rate for 54 patients with active disease was 85%. At a median follow-up of 12 months, 1-year regimen-related and treatment-related mortalities were 1% and 3%, respectively. Two patients had reversible hepatic veno-occlusive disease. Actuarial 1-year overall survival (OS) and event-free survival (EFS) were 65% and 52% for all patients, and 81% and 75% for patients receiving transplants in CR. Recipient age and donor type did not influence OS or EFS. Median busulfan clearance was 109 mL/min/m2 and median daily area-under-the-plasma-concentration-versus-time-curve was 4871 µmol-min, with negligible interdose variability in pharmacokinetic parameters. The results suggest that intravenous busulfan-fludarabine is an efficacious, reduced-toxicity, myeloablative-conditioning regimen for patients with AML or MDS undergoing HSCT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Fludarabine finds its significant other? John Barrett Blood 2004 104: 603-604. [Full Text] [PDF] This article has been cited by other articles: C. A. Ramos, R. M. Saliba, L. de Padua, O. Khorshid, E. J. Shpall, S. Giralt, P. A. Patah, C. M. Hosing, U. R. Popat, G. Rondon, et al. Impact of hepatitis C virus seropositivity on survival after allogeneic hematopoietic stem cell transplantation for hematologic malignancies Haematologica, February 1, 2009; 94(2): 249 - 257. [Abstract] [Full Text] [PDF] 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] M. L. Sorror, B. M. Sandmaier, B. E. Storer, M. B. Maris, F. Baron, D. G. Maloney, B. L. Scott, H. J. Deeg, F. R. Appelbaum, and R. Storb Comorbidity and Disease Status Based Risk Stratification of Outcomes Among Patients With Acute Myeloid Leukemia or Myelodysplasia Receiving Allogeneic Hematopoietic Cell Transplantation J. Clin. Oncol., September 20, 2007; 25(27): 4246 - 4254. [Abstract] [Full Text] [PDF] D. Blaise, N. Vey, C. Faucher, and M. Mohty Current status of reduced intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia Haematologica, April 1, 2007; 92(4): 533 - 541. [Abstract] [Full Text] [PDF] G. Akpek, A. Badros, A. P. Rapoport, K. Ruehle, K. Barton, B. Meisenberg, and S. Yanovich High Incidence of BK-Virus-Related Hemorrhagic Cystitis after Busulfan/Fludarabine Myeloablative Conditioning in Allogeneic Stem Cell Transplantation Recipients. Blood (ASH Annual Meeting Abstracts), November 16, 2006; 108(11): 5254 - 5254. [Abstract] [PDF] C. Schmid, M. Schleuning, R. Schwerdtfeger, B. Hertenstein, E. Mischak-Weissinger, D. Bunjes, S. v. Harsdorf, C. Scheid, U. Holtick, H. Greinix, et al. Long-term survival in refractory acute myeloid leukemia after sequential treatment with chemotherapy and reduced-intensity conditioning for allogeneic stem cell transplantation Blood, August 1, 2006; 108(3): 1092 - 1099. [Abstract] [Full Text] [PDF] S.-W. Kim, T. E. Tanimoto, N. Hirabayashi, S. Goto, M. Kami, S. Yoshioka, T. Uchida, K. Kishi, Y. Tanaka, A. Kohno, et al. Myeloablative allogeneic hematopoietic stem cell transplantation for non-Hodgkin lymphoma: a nationwide survey in Japan Blood, July 1, 2006; 108(1): 382 - 389. [Abstract] [Full Text] [PDF] S. Tauro, C. Craddock, K. Peggs, G. Begum, P. Mahendra, G. Cook, J. Marsh, D. Milligan, A. Goldstone, A. Hunter, et al. Allogeneic Stem-Cell Transplantation Using a Reduced-Intensity Conditioning Regimen Has the Capacity to Produce Durable Remissions and Long-Term Disease-Free Survival in Patients With High-Risk Acute Myeloid Leukemia and Myelodysplasia J. Clin. Oncol., December 20, 2005; 23(36): 9387 - 9393. [Abstract] [Full Text] [PDF] M. Stelljes, M. Bornhauser, M. Kroger, J. Beyer, M. C. Sauerland, A. Heinecke, B. Berning, C. Scheffold, G. Silling, T. Buchner, et al. Conditioning with 8-Gy total body irradiation and fludarabine for allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia Blood, November 1, 2005; 106(9): 3314 - 3321. [Abstract] [Full Text] [PDF] C. Schmid, M. Schleuning, G. Ledderose, J. Tischer, and H.-J. Kolb Sequential Regimen of Chemotherapy, Reduced-Intensity Conditioning for Allogeneic Stem-Cell Transplantation, and Prophylactic Donor Lymphocyte Transfusion in High-Risk Acute Myeloid Leukemia and Myelodysplastic Syndrome J. Clin. Oncol., August 20, 2005; 23(24): 5675 - 5687. [Abstract] [Full Text] [PDF] K. van Besien, A. Artz, S. Smith, D. Cao, S. Rich, L. Godley, D. Jones, P. Del Cerro, D. Bennett, B. Casey, et al. Fludarabine, Melphalan, and Alemtuzumab Conditioning in Adults With Standard-Risk Advanced Acute Myeloid Leukemia and Myelodysplastic Syndrome J. Clin. Oncol., August 20, 2005; 23(24): 5728 - 5738. [Abstract] [Full Text] [PDF] A. Spyridonidis, H. Bertz, G. Ihorst, C. Grullich, and J. Finke Hematopoietic cell transplantation from unrelated donors as an effective therapy for older patients (>= 60 years) with active myeloid malignancies Blood, May 15, 2005; 105(10): 4147 - 4148. [Full Text] [PDF] H. J. Deeg Optimization of Transplant Regimens for Patients with Myelodysplastic Syndrome (MDS) Hematology, January 1, 2005; 2005(1): 167 - 173. [Abstract] [Full Text] [PDF] S. Giralt Reduced-Intensity Conditioning Regimens for Hematologic Malignancies: What Have We Learned over the Last 10 Years? Hematology, January 1, 2005; 2005(1): 384 - 389. [Abstract] [Full Text] [PDF]

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