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Conditioning Regimens

Allogeneic bone marrow transplantation for childhood leukemia following a busulfan and melphalan preparative regimen

Abstract

Thirty children with leukemia underwent allogeneic bone marrow transplantation (BMT) following a radiation-free preparative regimen, from July 1988 to January 1996. Twelve males and 18 females, ages 9 months to 15 years (median 8.5 years), received busulfan (BU, 4 mg/kg/day for 4 days by mouth), followed by melphalan (L-PAM, 60–70 mg/m2/day i.v. for 3 days), and infusion of allogeneic marrow from an HLA-matched related donor. Diagnoses included acute myelogenous leukemia (n = 20), acute lymphoblastic leukemia (n = 8) and chronic myelogenous leukemia (n = 2). Twenty-five patients were transplanted in first complete remission (CR), three in second CR, and two patients with chronic myelogenous leukemia in the first chronic phase. Graft-versus-host disease (GVHD) prophylaxis consisted of methotrexate (MTX) alone in 27 patients and short-term MTX and cyclosporin A in three patients. Engraftment was achieved in all patients. Toxicities were mild or moderate. Six patients developed acute GVHD: four had grade I and two had grade II. Chronic GVHD was documented in eight patients. Three patients relapsed. As of September 1997, 27 patients were alive and well at 22–110 months (median 61) of follow-up. The disease-free survival rate at 5 years after BMT was 90%. A regimen consisting of high-dose BU and L-PAM without total body irradiation is useful for conditioning for allogeneic BMT in children with leukemia.

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Matsuyama, T., Kojima, S. & Kato, K. Allogeneic bone marrow transplantation for childhood leukemia following a busulfan and melphalan preparative regimen. Bone Marrow Transplant 22, 21–26 (1998). https://doi.org/10.1038/sj.bmt.1701276

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  • DOI: https://doi.org/10.1038/sj.bmt.1701276

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