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Busulfan‐based myeloablative conditioning regimens for haploidentical transplantation in high‐risk acute leukemias and myelodysplastic syndromes
Author(s) -
Gayoso Jorge,
Balsalobre Pascual,
Kwon Mi,
Herrera Pilar,
Bermúdez Arancha,
Sampol Antonia,
Jiménez Santiago,
LópezCorral Lucía,
Serrano David,
Piñana Jose Luis,
Pascual María J.,
Heras Inmaculada,
Bento Leyre,
Varela Rosario,
Humala Karem,
Zabalza Amaya,
Laiglesia Almudena,
BastosOreiro Mariana,
PérezCorral Ana,
MartínezLaperche Carolina,
Buño Ismael,
DíezMartín José L.
Publication year - 2018
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13103
Subject(s) - busulfan , cumulative incidence , medicine , myelodysplastic syndromes , transplantation , cyclophosphamide , regimen , acute leukemia , incidence (geometry) , hematopoietic stem cell transplantation , oncology , surgery , gastroenterology , leukemia , chemotherapy , bone marrow , physics , optics
Background High‐risk acute leukemia ( AL ) and myelodysplastic syndrome ( MDS ) remain a therapeutic challenge. Unmanipulated haploidentical‐related donor transplantation based on a myeloablative conditioning regimen ( HAPLO ‐ MAC ) and post‐transplant cyclophosphamide ( PT ‐Cy) as prophylaxis against graft vs host disease (Gv HD ) is now a promising rescue strategy that could become universally available. Objective To evaluate the results of HAPLO ‐ MAC with PT ‐Cy in patients with AL and MDS reported to the Haploidentical Transplantation Subcommittee of the Spanish Group for Hematopoietic Transplantation ( GETH ). Patients and methods We report our multicenter experience using an IV busulfan‐based HAPLO ‐ MAC regimen and PT ‐Cy for treatment of 65 adults with high‐risk AL and MDS . Results Engraftment was recorded in 64 patients (98.5%), with a median time to neutrophil and platelet recovery of 16 and 27 days, respectively. The cumulative incidence of grade II ‐ IV acute Gv HD and chronic Gv HD was 28.6% and 27.5%, respectively. After a median follow‐up of 31 months for survivors, the cumulative incidence of non‐relapse mortality and relapse at 2 years was 18.8% and 25%, respectively. Estimated 30‐month event‐free survival and overall survival were 56% and 54.5%, respectively. Conclusion HAPLO ‐ MAC comprising an IV busulfan‐based conditioning regimen enabled long‐term disease control with acceptable toxicity in high‐risk AL and MDS .