Fludarabine/busulfan versus busulfan/cyclophosphamide as myeloablative conditioning for myelodysplastic syndrome: a propensity score-matched analysis.
Busulfan
/ therapeutic use
Cyclophosphamide
/ therapeutic use
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Leukemia, Myeloid, Acute
/ therapy
Myelodysplastic Syndromes
/ therapy
Propensity Score
Retrospective Studies
Transplantation Conditioning
Vidarabine
/ analogs & derivatives
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
28
04
2021
accepted:
20
08
2021
revised:
05
08
2021
pubmed:
8
9
2021
medline:
11
3
2022
entrez:
7
9
2021
Statut:
ppublish
Résumé
Myeloablative conditioning with fludarabine/busulfan (Flu/Bu4) prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) is effective for acute myeloid leukemia. However, the effectiveness of Flu/Bu4 for myelodysplastic syndrome (MDS) remains poorly understood. Therefore, we retrospectively analyzed nationwide registry data in Japan from 2006 to 2018 and compared transplant outcomes of adult MDS patients receiving Flu/Bu4 and busulfan/cyclophosphamide (Bu4/Cy) using propensity score (PS) matching. The primary endpoint was overall survival (OS). Among 2,482 MDS patients, 153 patients were assigned each to the Flu/Bu4 and Bu4/Cy groups. The 3-year OS rates were 52.7% (95% confidence interval [CI], 43.8-60.8%) and 49.5% (95% CI, 40.8-57.6%) in the Flu/Bu4 and Bu4/Cy group, respectively (P = 0.548). The 3-year progression-free survival (P = 0.858), the cumulative incidence of relapse (P = 0.536), and cumulative incidence of non-relapse mortality (P = 0.684) were not significantly different between the two groups. According to the findings of subgroup analyses, no patient had a favorable OS when using either of the two regimens. In conclusion, although our PS-matched cohort mainly comprised older patients who had a low hematopoietic cell transplantation-comorbidity index and low-risk disease status, Flu/Bu4 could be an alternative to Bu4/Cy for MDS patients prior to allo-HSCT.
Identifiants
pubmed: 34489555
doi: 10.1038/s41409-021-01447-y
pii: 10.1038/s41409-021-01447-y
doi:
Substances chimiques
Cyclophosphamide
8N3DW7272P
Vidarabine
FA2DM6879K
Busulfan
G1LN9045DK
fludarabine
P2K93U8740
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3008-3015Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
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