Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Conditioning Regimens

Survival, disease-free survival and adverse effects of conditioning for allogeneic bone marrow transplantation with busulfan/ cyclophosphamide vs total body irradiation: a meta-analysis

Abstract

Randomized, prospective studies comparing BUCY to TBI conditioning regimens for allogeneic bone marrow transplantation have yielded conflicting results. We investigated the overall survival, the disease-free survival and the toxicities of BUCY vs TBI-based regimens by conducting a meta-analysis of all published, randomized, prospective trials comparing these regimens. Five studies were analyzed. We evaluated six endpoints: survival, disease-free survival, veno-occlusive disease (VOD) of the liver, acute GVHD, chronic GVHD, and interstitial pneumonitis. We combined individual study results using a random effects model. Survival and disease-free survival were better with TBI-based regimens than with BUCY, but these differences were not statistically significant (survival odds ratio 1.4, 95% confidence interval 0.9–2.2, P = 0.09; disease-free survival odds ratio 1.2, 95% confidence interval 0.7–2.1, P = 0.44). A power analysis indicated that BUCY was unlikely to have a clinically relevant survival or disease-free survival advantage. The power analysis could not exclude the possibility of such an advantage for TBI-based regimens. A significantly greater incidence of VOD occurred with BUCY (odds ratio 2.5, 95% confidence interval 1.2–5.2, P = 0.02). For the other side-effects, there were no significant differences. We concluded that TBI-based regimens cause less VOD than BUCY and are at least as good for survival and disease-free survival.

Author information

Affiliations

Authors

Corresponding author

Correspondence to JJ Dillon.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hartman, AR., Williams, S. & Dillon, J. Survival, disease-free survival and adverse effects of conditioning for allogeneic bone marrow transplantation with busulfan/ cyclophosphamide vs total body irradiation: a meta-analysis. Bone Marrow Transplant 22, 439–443 (1998). https://doi.org/10.1038/sj.bmt.1701334

Download citation

Keywords

  • bone marrow transplantation,
  • busulfan
  • cyclophosphamide
  • whole-body irradiation
  • meta-analysis

Further reading

Search

Quick links