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Conditioning Regimens

Intravenous BU plus Mel: an effective, chemotherapy-only transplant conditioning regimen in patients with ALL

Bone Marrow Transplantation volume 48, pages 26–31 (2013)Cite this article

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Abstract

We investigated the administration of i.v. BU combined with melphalan (Mel) in patients with ALL undergoing allogeneic hematopoietic SCT. Forty-seven patients with a median age of 33 years (range 20–61) received a matched sibling (n=27) or matched unrelated donor transplant (n=20) for ALL in first CR (n=26), second CR (n=13), or with more advanced disease (n=8). BU was infused daily for 4 days, either at a fixed dose of 130 mg/m2 (5 patients) or using pharmacokinetic (PK) dose adjustment (42 patients), to target an average daily area-under-the-curve (AUC) of 5000 μmol/min, determined by a test dose of i.v. BU at 32 mg/m2. This was followed by a rest day, then two daily doses of Mel at 70 mg/m2. Stem cells were infused on the following day. The 2-year OS, PFS and non-relapse mortality (NRM) rates were 35% (95% confidence interval (CI), 23–51%), 31% (95% CI, 21–48%) and 37% (95% CI, 23–50%), respectively. Acute NRM at 100 days was favorable at 12% (95% CI, 5–24%); however, the 2-year NRM was significantly higher for patients older than 40 years, 58% vs 20%, mainly due to GVHD.

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Authors and Affiliations

  1. Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    P Kebriaei, C Ledesma, M de Lima, E J Shpall, C Hosing, M Qazilbash, U Popat, A Alousi, Y Nieto, R E Champlin, R B Jones & B S Andersson

  2. Department of Experimental Therapeutics and Pharmaceutical Development Center, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    T Madden

  3. Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    X Wang & P F Thall

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Correspondence to P Kebriaei.

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Kebriaei, P., Madden, T., Wang, X. et al. Intravenous BU plus Mel: an effective, chemotherapy-only transplant conditioning regimen in patients with ALL. Bone Marrow Transplant 48, 26–31 (2013). https://doi.org/10.1038/bmt.2012.114

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