Popat UR, Pasvolsky O, Bassett R, et al. Myeloablative Fractionated Busulfan for Allogeneic Stem Cell Transplant in Older Patients or Patients with Comorbidities. Blood Advances. 2023; (doi: 10.1182/bloodadvances.2023010850).
A Phase II trial of myeloablative fractionated busulfan yielded low non-relapse mortality (NRM) rates among older patients and patients with comorbidities who are undergoing allogeneic hematopoietic stem cell transplantation (alloHCT), without increasing relapse rates. A total of 78 patients, median age 61 years, received busulfan 80 mg/m2 on days -20 and -13 prior to transplant. Patients received fludarabine 40 mg/m2 on days -6 to -2, before receiving busulfan at doses intended to realize a target area under the curve of 20,000 mol/minute for the entire regimen. Twenty-four percent of patients underwent alloHCT for acute leukemia, 27% had myelodysplastic syndrome, and 44% had myeloproliferative disorder/chronic myelogenous leukemia. Thirty-four patients (44%) had an HCT-specific comorbidity index (HCT-CI) of >3. NRM at 100 days, 1 year, and 3 years was 3.8%, 8%, and 9.3%, respectively, with no significant differences in age or HCT-CI scores at a median follow-up of 36.4 months. The incidence of relapse was 10% at 1 year and 18% at 3 years. Overall survival at 3 years was 80%, with similar rates for patients aged >60 and <60 years and those with HCT-CI>3 and HCT-CI<3.
Tags: AlloHCT, patient care, transplantation, Patients, Cellular therapy, cell therapy, medical, Allo-HCT, patient, all-HCT