Oral fludarabine is an effective and convenient alternative to intravenous fludarabine in fludarabine melphalan based reduced intensity conditioning regimens

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  1. 1.

    Barrett A, Savani B. Stem cell transplantation with reduced-intensity conditioning regimens: a review of ten years experience with new transplant concepts and new therapeutic agents. Leukemia. 2006;20:1661.

  2. 2.

    Foran JM, Oscier D, Orchard J, Johnson SA, Tighe M, Cullen MH, et al. Pharmacokinetic study of single doses of oral fludarabine phosphate in patients with “low-grade” non-Hodgkin’s lymphoma and B-cell chronic lymphocytic leukemia. J Clin Oncol. 1999;17:1574.

  3. 3.

    Boogaerts M, Van Hoof A, Catovsky D, Kovacs M, Montillo M, Zinzani P, et al. Activity of oral fludarabine phosphate in previously treated chronic lymphocytic leukemia. J Clin Oncol. 2001;19:4252–8.

  4. 4.

    Ruutu T, Volin L, Parkkali T, Juvonen E, Elonen E. Cyclosporine, methotrexate, and methylprednisolone compared with cyclosporine and methotrexate for the prevention of graft-versus-host disease in bone marrow transplantation from HLA-identical sibling donor: a prospective randomized study. Blood. 2000;96:2391–8.

  5. 5.

    Przepiorka D, Weisdorf D, Martin P, Klingemann H, Beatty P, Hows J, et al. 1994 Consensus conference on acute GVHD grading. Bone Marrow Transpl. 1995;15:825–8.

  6. 6.

    Shulman HM, Sullivan KM, Weiden PL, McDonald GB, Striker GE, Sale GE, et al. Chronic graft-versus-host syndrome in man: a long-term clinicopathologic study of 20 Seattle patients. Am J Med. 1980;69:204–17.

  7. 7.

    Oran B, Giralt S, Saliba R, Hosing C, Popat U, Khouri I, et al. Allogeneic hematopoietic stem cell transplantation for the treatment of high-risk acute myelogenous leukemia and myelodysplastic syndrome using reduced-intensity conditioning with fludarabine and melphalan. Biol Blood Marrow Transpl. 2007;13:454–62.

  8. 8.

    Bryant A, Nivison-Smith I, Pillai E, Kennedy G, Kalff A, Ritchie D, et al. Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients. Bone Marrow Transpl. 2014;49:17.

  9. 9.

    Kröger N, Solano C, Wolschke C, Bandini G, Patriarca F, Pini M, et al. Antilymphocyte globulin for prevention of chronic graft-versus-host disease. New Engl J Med. 2016;374:43–53.

  10. 10.

    von dem Borne PA, Starrenburg CW, Barge RM, Marijt EW, Falkenburg JH, Willemze R. Comparable engraftment and chimerism kinetics using oral and intravenous fludarabine as part of a reduced intensity conditioning regimen. Bone Marrow Transpl. 2008;42:137–8.

  11. 11.

    Velazquez-Sanchez-de-Cima S, Zamora-Ortiz G, Hernandez-Reyes J, Rosales-Duron AD, Gonzalez-Ramirez MP, Martagon-Herrera NA, et al. Oral versus intravenous fludarabine as part of a reduced-intensity conditioning for allogeneic stem cell transplantation. Acta Haematol. 2014;132:125–8.

  12. 12.

    Delgado J, Marco A, Moreno E, Pinana J, Valcarcel D, Martino R, et al. Reduced-intensity conditioning allogeneic hematopoietic cell transplantation using oral fludarabine as part of the conditioning regimen. Cytotherapy. 2009;11:356–61.

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We would like to thank our clinical colleagues in the haematology department and the blood and marrow transplantation team at Royal North Shore Hospital for their contribution to patient care.

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Correspondence to Y. Lwin.

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Lwin, Y., Lindsay, J., Reid, C. et al. Oral fludarabine is an effective and convenient alternative to intravenous fludarabine in fludarabine melphalan based reduced intensity conditioning regimens. Bone Marrow Transplant (2019) doi:10.1038/s41409-019-0713-z

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