Fractionated Busulfan preparative regimen for alloHSCT

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.

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Tags: AlloHCT, patient care, transplantation, Patients, Cellular therapy, cell therapy, medical, Allo-HCT, patient, all-HCT

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