Unrelated-donor bone marrow transplantation with a conditioning regimen including fludarabine, busulfan, and 4 Gy total body irradiation

Yasushi Onishi, Shin Ichiro Mori, Shigeru Kusumoto, Kyoko Sugimoto, Daigo Akahane, Yuriko Morita-Hoshi, Sung Won Kim, Takahiro Fukuda, Yuji Heike, Ryuji Tanosaki, Kensei Tobinai, Yoichi Takaue

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

We investigated the feasibility of reduced-intensity conditioning with 4 Gy total body irradiation, fludarabine (30 mg/m2 for 6 days), and busulfan (4 mg/kg for 2 days) for bone marrow transplantation from a serologically HLA-matched unrelated donor. Seventeen adult patients (median age, 55 years; range, 27-67 years) with various hematologic malignancies (6 in remission, 11 not in remission) were treated. Successful engraftment was achieved in all patients at a median of day 18 (range, day 14-35) after transplantation, although subsequent secondary graft failure was observed in 2 patients. The cumulative incidence of acute graft-versus-host disease (GVHD) of grades II to IV at day 100 was 48%. With a median follow-up of 286 days (range, 56-687 days), the rates of 1-year overall survival, 100-day nonrelapse mortality, and 1-year nonrelapse mortality were 41%, 14%, and 46%, respectively. Eleven patients died, and the causes of death were relapse (n = 4), pulmonary complications (n = 4), acute GVHD (n = 2), and sepsis (n = 1). The remaining 6 patients (at transplantation, 2 were in remission, and 4 were not in remission) are currently still in remission. These results suggest that this regimen reduces the risk of graft failure, but further studies are needed to ameliorate transplantation-related toxicities, primarily GVHD and/or pulmonary complications.

Original languageEnglish
Pages (from-to)256-263
Number of pages8
JournalInternational Journal of Hematology
Volume85
Issue number3
DOIs
Publication statusPublished - 2007 Apr
Externally publishedYes

Fingerprint

Busulfan
Unrelated Donors
Whole-Body Irradiation
Bone Marrow Transplantation
Graft vs Host Disease
Transplantation
Transplants
Lung
Mortality
Hematologic Neoplasms
Cause of Death
Sepsis
fludarabine
Recurrence
Survival
Incidence

Keywords

  • Busulfan
  • Fludarabine
  • TBI
  • Unrelated donor bone marrow transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

Unrelated-donor bone marrow transplantation with a conditioning regimen including fludarabine, busulfan, and 4 Gy total body irradiation. / Onishi, Yasushi; Mori, Shin Ichiro; Kusumoto, Shigeru; Sugimoto, Kyoko; Akahane, Daigo; Morita-Hoshi, Yuriko; Kim, Sung Won; Fukuda, Takahiro; Heike, Yuji; Tanosaki, Ryuji; Tobinai, Kensei; Takaue, Yoichi.

In: International Journal of Hematology, Vol. 85, No. 3, 04.2007, p. 256-263.

Research output: Contribution to journalArticle

Onishi, Y, Mori, SI, Kusumoto, S, Sugimoto, K, Akahane, D, Morita-Hoshi, Y, Kim, SW, Fukuda, T, Heike, Y, Tanosaki, R, Tobinai, K & Takaue, Y 2007, 'Unrelated-donor bone marrow transplantation with a conditioning regimen including fludarabine, busulfan, and 4 Gy total body irradiation', International Journal of Hematology, vol. 85, no. 3, pp. 256-263. https://doi.org/10.1532/IJH97.06199
Onishi, Yasushi ; Mori, Shin Ichiro ; Kusumoto, Shigeru ; Sugimoto, Kyoko ; Akahane, Daigo ; Morita-Hoshi, Yuriko ; Kim, Sung Won ; Fukuda, Takahiro ; Heike, Yuji ; Tanosaki, Ryuji ; Tobinai, Kensei ; Takaue, Yoichi. / Unrelated-donor bone marrow transplantation with a conditioning regimen including fludarabine, busulfan, and 4 Gy total body irradiation. In: International Journal of Hematology. 2007 ; Vol. 85, No. 3. pp. 256-263.
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