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Autologous hematopoietic cell transplantation using dose-reduced intravenous busulfan, melphalan, and thiotepa for high-risk or relapsed lymphomas

Bone Marrow Transplantation volume 54, pages 330–333 (2019)Cite this article

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In both the pre- and post-rituximab eras, high-dose chemotherapy with autologous hematopoietic cell transplantation (auto-HCT) has been shown to be effective for chemosensitive relapsed non-Hodgkin’s lymphoma (NHL) [1,2,3]. Most previous studies used myeloablative conditioning regimens based on carmustine or total body irradiation (TBI) plus etoposide plus an alkylating agent, which showed a progression-free survival (PFS) rate ranging from 30% to 60% and resulted in transplant-related mortality in 3–24% of patients [4]. A previously introduced conditioning regimen consisting of triple alkylating agents (BU-MEL-TT)—busulfan (12 mg/kg), melphalan (100 mg/m2), and thiotepa (500 mg/m2)—was used in various malignancies and appeared to have a benefit, especially for lymphoma and myeloma patients with prior irradiation therapy [5,6,7]. However, the triple alkylating regimen also has toxic complications such as mucositis, hepatotoxicity, and hepatic veno-occlusive disease (VOD) [8, 9]. Therefore, for relapsed or high-risk NHL patients we have consistently used a conditioning regimen of BU-MEL-TT with dose reduction for all alkylating agents to avoid excessive regimen-related toxicity and transplant-related mortality.

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Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2016R1A2B4007282) and supported by research fund of Seoul St. Mary’s Hospital, The Catholic University of Korea.

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  1. Department of Hematology, Leukemia Research Institute, Seoul St. Mary’s Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Jae-Ho Yoon, Gi June Min, Sung-Soo Park, Young-Woo Jeon, Sung-Eun Lee, Byung-Sik Cho, Ki-Seong Eom, Yoo-Jin Kim, Seok Lee, Hee-Je Kim, Chang-Ki Min, Jong Wook Lee & Seok-Goo Cho

  2. Institute for Translational Research and Molecular Imaging, The Catholic University of Korea College of Medicine, Seoul, Korea

    Seok-Goo Cho

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Yoon, JH., Min, G.J., Park, SS. et al. Autologous hematopoietic cell transplantation using dose-reduced intravenous busulfan, melphalan, and thiotepa for high-risk or relapsed lymphomas. Bone Marrow Transplant 54, 330–333 (2019). https://doi.org/10.1038/s41409-018-0289-z

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