¹Stem Cell Transplant Program, Section of Hematology/Oncology, University of Illinois at Chicago, Chicago, IL, USA

Correspondence: Dr D Rondelli, Stem Cell Transplant Program, Section Hematology/Oncology, University of Illinois at Chicago, 909 S Wolcott Ave, Room 3099 MC734, Chicago, IL 60612, USA. E-mail: drond@uic.edu

Received 21 September 2007; Revised 30 November 2007; Accepted 4 January 2008; Published online 11 February 2008.

Abstract

In this study, we utilized a conditioning regimen with fludarabine and myeloablative dose i.v. BU (12.8 mg/kg) (FluBU) in 36 adult patients (median age: 44 years, range: 18–61) with myeloid or lymphoid malignancies at standard risk (n=10) or high risk of relapse (n=26), who received an allogeneic hematopoietic SCT (HSCT) from HLA-matched related (n=16) or unrelated (n=20) donors. The source of hematopoietic stem cells was peripheral blood in 28 and marrow in 8 cases. Rabbit-antithymocyte globulin at 7 mg/kg was utilized in 21 patients. Acute GVHD grade II–IV was observed in 19% of the patients (grade III–IV in 14% of patients) and chronic GVHD in 11 of 30 evaluable patients (37% ). At median follow-up of 737 days (range: 152–1737) for alive patients, overall survival rates in standard- and high-risk patients were 80 and 35% , respectively, and event-free survival rates were 70 and 31% , respectively. TRM was 10% in standard-risk and 19% in high-risk patients. Post transplant relapse was observed in 20% standard-risk and in 46% high-risk patients. FluBU conditioning regimen is associated with a limited hematologic and extrahematologic toxicity and with an antitumor activity comparable to other standard myeloablative regimens.