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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 (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 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 Social Bookmarking                   What's this? Submitted February 20, 2002 Accepted April 4, 2002 Conditioning with Targeted Busulfan and Cyclophosphamide for Hemopoietic Stem Cell Transplantation from Related and Unrelated Donors in Patients with Myelodysplastic Syndrome H J 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 Division of Clinical Research, Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA, USA; Department of Medicine, UW, Seattle, WA, USA Division of Clinical Research, Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA, USA; Division of Public Health Sciences, FHCRC, Seattle, WA, USA; Department of Biostatistics, University of Washington (UW), Seattle, WA, USA Division of Clinical Research, Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA, USA; Department of Pharmaceutics, UW, Seattle, WA, USA Division of Clinical Research, Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA, USA Division of Clinical Research, Fred Hutchinson Cancer Research Center (FHCRC), Seattle, WA, USA; Department of Pathology, UW, Seattle, WA, USA Department of Medicine, UW, Seattle, WA, USA; VA Medical Center, Seattle, WA, USA * Corresponding author; email: jdeeg{at}fhcrc.org. One hundred and nine patients with myelodysplastic syndrome (MDS) aged 6-66 (median 46) years were treated with busulfan (BU) targeted to plasma concentrations of 800-900 ng/mL plus cyclophosphamide (CY), 2 x 60 mg/kg, and hemopoietic stem cell transplantation (HSCT) from related (n = 45) or unrelated donors (n = 64). At the time of transplant, 69 patients had less than 5% myeloblasts in the marrow, and 40 had more advanced disease. All but two evaluable patients engrafted. 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. Non-relapse mortality 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 > treatment related; P = .03). Factors significantly correlated with relapse were advanced FAB classification (P = .002) and IPSS score (P = .009), poor risk cytogenetics (P = .03), and treatment-related etiology (P = .03). None of the factors examined was statistically significant for non-relapse mortality. Patient age and donor type had no significant impact on outcome. RFS tended to be superior in patients transplanted with peripheral blood rather than marrow stem cells. Thus, a targeted BUCY regimen provided effective transplant conditioning for patients with MDS transplanted from HLA-identical siblings or alternative donors. While there was still considerable non-relapse morbidity and mortality, the present regimen was used successfully even in patients more than 60 years of age. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: R. Marks, K. Potthoff, J. Hahn, G. Ihorst, H. Bertz, A. Spyridonidis, E. Holler, and J. M. 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