[Comparison of two conditioning regimens in treatment of leukemia by allogeneic hematopoietic stem cell transplantation]

Abstract

Background & objective: The conditioning regimens are the critical factors in the allogeneic hematopoietic stem cell transplantation. This study was conducted to compare the effectiveness and side-effects of two conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods: Twenty-one cases received busulfan(BU) 16 mg/kg plus cyclophosphamide(CY) 120 mg/kg,the other 23 cases received total body irradiation(TBI) 7.5-8.5 Gy plus CY 120 mg/kg regimen.

Results: The 3-year disease-free survivals (DFS) were 61.5% in BU/CY group and 64.7% in TBI/CY group, respectively (P >0.05). The relapse rates were 23.8% and 26%, respectively, without significant difference (P >0.05). The incidence of liver damage in the BU/CY group was higher (80.9%) than that in the TBI/CY group (54.3%) (P< 0.05), while no case developed hepatic veno-occlusive disease. Stomatitis and gastrointestinal toxicity were significantly lower in the BU/CY group (33.3% and 42.9%) compared with TBI/CY group (78.2% and 78.2%), respectively (P< 0.05). Bladder toxicity (23.8% and 26%) and pulmonary toxicity(14.3% and 13%) were similar in the two groups(P >0.05), while one patient in TBI/CY group developed grade IV pulmonary toxicity, which is lethal. No case was found to have cardiac, renal, or central nervous system grade I toxicity.

Conclusion: The two groups have equal effectiveness, BU/CY regimen is relatively easy to administer and well tolerated with low extramedullary toxicity.