International Journal of Hematology

, Volume 85, Issue 3, pp 256–263 | Cite as

Unrelated-Donor Bone Marrow Transplantation with a Conditioning Regimen Including Fludarabine, Busulfan, and 4 Gy Total Body Irradiation

  • Yasushi Onishi
  • Shin-ichiro Mori
  • Shigeru Kusumoto
  • Kyoko Sugimoto
  • Daigo Akahane
  • Yuriko Morita-Hoshi
  • Sung-Won Kim
  • Takahiro Fukuda
  • Yuji Heike
  • Ryuji Tanosaki
  • Kensei Tobinai
  • Yoichi Takaue
Article

Abstract

We investigated the feasibility of reduced-intensity conditioning with 4 Gy total body irradiation, fludarabine (30 mg/m2 for 6 days), and busulfan (4 mg/kg for 2 days) for bone marrow transplantation from a serologically HLA-matched unrelated donor. Seventeen adult patients (median age, 55 years; range, 27-67 years) with various hematologic malignancies (6 in remission, 11 not in remission) were treated. Successful engraftment was achieved in all patients at a median of day 18 (range, day 14-35) after transplantation, although subsequent secondary graft failure was observed in 2 patients. The cumulative incidence of acute graft-versus-host disease (GVHD) of grades II to IV at day 100 was 48%. With a median follow-up of 286 days (range, 56-687 days), the rates of 1-year overall survival, 100-day nonrelapse mortality, and 1-year nonrelapse mortality were 41%, 14%, and 46%, respectively. Eleven patients died, and the causes of death were relapse (n = 4), pulmonary complications (n = 4), acute GVHD (n = 2), and sepsis (n = 1). The remaining 6 patients (at transplantation, 2 were in remission, and 4 were not in remission) are currently still in remission. These results suggest that this regimen reduces the risk of graft failure, but further studies are needed to ameliorate transplantation-related toxicities, primarily GVHD and/or pulmonary complications. cr 2007 The Japanese Society of Hematology

Key words

Unrelated donor bone marrow transplantation Fludarabine Busulfan, TBI 

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Copyright information

© The Japanese Society of Hematology 2007

Authors and Affiliations

  • Yasushi Onishi
    • 1
  • Shin-ichiro Mori
    • 1
  • Shigeru Kusumoto
    • 1
  • Kyoko Sugimoto
    • 1
  • Daigo Akahane
    • 1
  • Yuriko Morita-Hoshi
    • 1
  • Sung-Won Kim
    • 1
  • Takahiro Fukuda
    • 1
  • Yuji Heike
    • 1
  • Ryuji Tanosaki
    • 1
  • Kensei Tobinai
    • 1
  • Yoichi Takaue
    • 1
  1. 1.Division of Hematology and Hematopoietic Stem Cell TransplantationNational Cancer Center HospitalTokyoJapan

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