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Conditioning Regimens

Significance of additional high-dose cytarabine in combination with cyclophosphamide plus total body irradiation regimen for allogeneic stem cell transplantation

Bone Marrow Transplantation volume 39, pages 25–30 (2007)Cite this article

Abstract

The combination of cyclophosphamide (CY) and total body irradiation (TBI) has been used as a standard conditioning regimen for allogeneic transplantation. Several studies showed an advantage of adding high-dose cytarabine (HDCA) to this regimen. To clarify the significance of additional HDCA, we conducted a retrospective multicenter study and compared the clinical results of these two regimens. From June 1985 to March 2003, 219 patients with hematological malignancies underwent allogeneic transplantation after conditioning with CY+TBI 12Gy (n=73) or CA+CY+TBI 12Gy (n=146). Engraftment, overall survival, transplant-related mortality (TRM), relapse rate and incidence of graft-versus-host disease (GVHD) were compared according to risks and donors. Addition of HDCA had no impact on the relapse rate in all subgroups, and it was associated with lower TRM among standard-risk patients after related transplantation, and with higher TRM and worse survival among standard-risk patients after unrelated transplantation. The incidence of acute GVHD was not significantly different between the two regimens, and HDCA resulted in a higher incidence of chronic GVHD among standard-risk patients after related transplantation. In summary, addition of HDCA is not beneficial for high-risk patients, and is not recommended for standard-risk patients receiving unrelated transplantation.

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Acknowledgements

We are indebted to the members of the Nagoya Blood and Marrow Transplantation Group for their helpful cooperation.

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Author notes

  1. Y Inamoto and T Nishida: These authors contributed equally to this study and should both be regarded as first authors.

Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    Y Inamoto, T Nishida, K Miyamura & Y Kodera

  2. Division of Molecular Medicine, Aichi Cancer Center, Nagoya, Japan

    R Suzuki

  3. Department of Hematology, Meitetsu Hospital, Nagoya, Japan

    H Sao & H Iida

  4. Department of Hematology, Nagoya University School of Medicine, Nagoya, Japan

    T Naoe

  5. Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan

    F Maruyama

  6. Department of Hematology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    N Hirabayashi

  7. Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    M Hamaguchi

  8. Department of Hematology and Oncology, Institute of Medical Science, University of Tokyo, Tokyo, Japan

    T Iseki

  9. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    M Kami

  10. Department of Hematology, Hamamatsu Medical Center, Shizuoka, Japan

    K Yano

  11. Department of Hematology, Ekisaikai Hospital, Nagoya, Japan

    H Takeyama

  12. Department of Hematology and Oncology, JA Aichi Showa Hospital, Konan, Japan

    Y Morishita

  13. Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan

    Y Morishima

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  1. Y Inamoto
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Correspondence to Y Inamoto.

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Inamoto, Y., Nishida, T., Suzuki, R. et al. Significance of additional high-dose cytarabine in combination with cyclophosphamide plus total body irradiation regimen for allogeneic stem cell transplantation. Bone Marrow Transplant 39, 25–30 (2007). https://doi.org/10.1038/sj.bmt.1705543

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  • DOI: https://doi.org/10.1038/sj.bmt.1705543

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