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Blood, 15 July 2008, Vol. 112, No. 2, pp. 415-425. Prepublished online as a Blood First Edition Paper on May 1, 2008; DOI 10.1182/blood-2007-08-104745. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-08-104745v1 112/2/415    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 CrossRef Citing Articles via Google Scholar Google Scholar Articles by Marks, R. Articles by Finke, J. M. Search for Related Content PubMed PubMed Citation Articles by Marks, R. Articles by Finke, J. M. Related Collections Neoplasia Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION Reduced-toxicity conditioning with fludarabine, BCNU, and melphalan in allogeneic hematopoietic cell transplantation: particular activity against advanced hematologic malignancies Reinhard Marks1, Karin Potthoff1, Joachim Hahn2, Gabriele Ihorst3, Hartmut Bertz1, Alexandros Spyridonidis1, Ernst Holler2, and Jürgen M. Finke1 1 Department of Haematology and Oncology, Albert-Ludwigs University Medical Center, Freiburg; 2 Department of Haematology and Oncology, University of Regensburg Medical Center, Regensburg; and 3 Institute of Medical Biometry and Medical Informatics, Albert-Ludwigs University, Freiburg, Germany Toxicity-reduced conditioning is being used for allogeneic stem cell transplantation in older and/or comorbid patients. We report on the treatment of 133 patients (median age: 55.6 years [23-73 years]) with acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS; n = 81), myeloproliferative syndromes (MPS; n = 20), and lymphoid malignancies (n = 32) using conditioning with FBM: fludarabine (5 x 30 mg/m2), 1,3-bis(2-chloroethyl)-1-nitrosourea (or carmustine, BCNU; 2 x 200 mg/m2), and melphalan (140 mg/m2). Patients 55 years or older received fludarabine with reduced BCNU (2 x150 mg/m2) and melphalan (110 mg/m2). After engraftment, chimerism analyses revealed complete donor hematopoiesis in 95.7% of patients. With a median follow-up of 58.5 months, 3- and 5-year overall survival (OS) was 53.0% and 46.1%, event-free survival (EFS) was 46.4% and 41.9%. No significant differences in OS and EFS were evident considering disease status (early vs advanced), patient age (<55 vs55 years), or donor type (related vs unrelated) in univariate and multivariate analyses. The cumulative 5-year incidence of death due to relapse was 20.1%. Nonrelapse mortality (NRM) after 100 days and 1 year was 15.8% and 26.3%. Among patients with AML/MDS, advanced cases (n = 64, including 61 with active disease) showed an OS of 44.6% and 42.4% after 3 and 5 years, respectively. Therefore, FBM conditioning combines effective disease control with low NRM. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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