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Substitution of cyclophosphamide in the modified BuCy regimen with fludarabine is associated with increased incidence of severe pneumonia: a prospective, randomized study
Liu, Dai-hong1; Xu, Lan-ping1; Zhang, Xiao-hui1; Wang, Yu1; Yan, Chen-hua1; Wang, Jing-zhi1; Wang, Feng-rong1; Sun, Yu-Qian1; Ji, Yu1; Zhang, Yuan-yuan1; Liu, Kai-yan1; Huang, Xiao-jun1,2
关键词Conditioning Regimen Fludarabine Cyclophosphamide Pneumonia
刊名INTERNATIONAL JOURNAL OF HEMATOLOGY
2013-12-01
DOI10.1007/s12185-013-1460-3
98期:6页:708-715
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Hematology
研究领域[WOS]Hematology
关键词[WOS]STEM-CELL TRANSPLANTATION ; BONE-MARROW-TRANSPLANTATION ; VERSUS-HOST-DISEASE ; CONDITIONING REGIMEN ; TOXICITY ; BUSULFAN
英文摘要

The modified busulfan-cyclophosphamide (mBuCy) regimen, combined with hydroxyurea, cytarabine and semustine, is the most frequently used myeloablative conditioning regimen for allogeneic hematopoietic stem cell transplantation in our unit. It is unknown, however, whether fludarabine can be substituted for cyclophosphamide in the mBuCy regimen. We carried out a prospective study to compare modified busulfan-fludarabine (mBuF) with mBuCy, aiming to reduce the treatment-related mortality, with non-inferiority of other outcomes. The mBuCy regimen consisted of hydroxyurea 80 mg/kg on day -10; cytarabine 2 g/m(2) on day -9; busulfan 9.6 mg/kg, intravenously on day -8 through -6; and cyclophosphamide 3.6 g/m(2) on day -5 and -4 and semustine 250 mg/m(2) on day -3. In the mBuF regimen, cyclophosphamide was substituted with fludarabine 30 mg/m(2) through day -5 to -1. Mobilized blood and marrow stem cells were collected from HLA-matched siblings. The trial was suspended due to a tendency of higher incidence of severe pneumonia in the mBuF arm, in which 105 patients were enrolled. After follow-up for another 22 months, a significantly increased incidence of severe pneumonia (31.1 %) was observed in the mBuF arm (11.6 % in mBuCy). This finding suggests that it is uncertain whether it is appropriate to substitute fludarabine for cyclophosphamide under any drug combination. This study was registered at www.chictr.org/cn under identifier ChiCTR-TRC-09000470.

语种英语
WOS记录号WOS:000328481700013
项目编号30971292 ; 2008BAI61B01
资助机构National Natural Science Foundation of China ; National Clinical Priority Specialty of Ministry of Health of China and National Science &amp ; Technology Pillar Program
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/51741
专题北京大学第二临床医学院_血液科
作者单位1.Peking Tsinghua Ctr Life Sci, Beijing 100871, Peoples R China
2.Peking Univ, Peoples Hosp, Inst Hematol, Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing 100044, Peoples R China
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GB/T 7714
Liu, Dai-hong,Xu, Lan-ping,Zhang, Xiao-hui,et al. Substitution of cyclophosphamide in the modified BuCy regimen with fludarabine is associated with increased incidence of severe pneumonia: a prospective, randomized study[J]. INTERNATIONAL JOURNAL OF HEMATOLOGY,2013,98(6):708-715.
APA Liu, Dai-hong.,Xu, Lan-ping.,Zhang, Xiao-hui.,Wang, Yu.,Yan, Chen-hua.,...&Huang, Xiao-jun.(2013).Substitution of cyclophosphamide in the modified BuCy regimen with fludarabine is associated with increased incidence of severe pneumonia: a prospective, randomized study.INTERNATIONAL JOURNAL OF HEMATOLOGY,98(6),708-715.
MLA Liu, Dai-hong,et al."Substitution of cyclophosphamide in the modified BuCy regimen with fludarabine is associated with increased incidence of severe pneumonia: a prospective, randomized study".INTERNATIONAL JOURNAL OF HEMATOLOGY 98.6(2013):708-715.
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