TY - JOUR
T1 - Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia
AU - Kato, Motohiro
AU - Takahashi, Yoshiyuki
AU - Tomizawa, Daisuke
AU - Okamoto, Yasuhiro
AU - Inagaki, Jiro
AU - Koh, Katsuyoshi
AU - Ogawa, Atsushi
AU - Okada, Keiko
AU - Cho, Yuko
AU - Takita, Junko
AU - Goto, Hiroaki
AU - Sakamaki, Hisashi
AU - Yabe, Hiromasa
AU - Kawa, Keisei
AU - Suzuki, Ritsuro
AU - Kudo, Kazuko
AU - Kato, Koji
PY - 2013/12
Y1 - 2013/12
N2 - Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n=198) or oral busulfan (oral-BU) (n=262) myeloablative conditioning. OS at 3years was 53.4%±3.7% with iv-BU and 55.1%±3.1% with oral-BU; the difference was not statistically significant (P= 77). OS at 3years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4%±5.5% with iv-BU and 54.6%±4.1 with oral-BU (P= 51) and 51.0%±5.0% with iv-BU and 55.8%±4.8% with oral-BU (P= 83), respectively. Cumulative incidence of relapse at 3years with iv-BU was similar to that with oral-BU (39.0%±3.6% and 36.4%±3.1%, respectively; P= 67). Cumulative incidence of NRM at 3years was 16.6%±2.7% with iv-BU and 18.3%±2.5% with oral-BU (P= 51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia.
AB - Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n=198) or oral busulfan (oral-BU) (n=262) myeloablative conditioning. OS at 3years was 53.4%±3.7% with iv-BU and 55.1%±3.1% with oral-BU; the difference was not statistically significant (P= 77). OS at 3years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4%±5.5% with iv-BU and 54.6%±4.1 with oral-BU (P= 51) and 51.0%±5.0% with iv-BU and 55.8%±4.8% with oral-BU (P= 83), respectively. Cumulative incidence of relapse at 3years with iv-BU was similar to that with oral-BU (39.0%±3.6% and 36.4%±3.1%, respectively; P= 67). Cumulative incidence of NRM at 3years was 16.6%±2.7% with iv-BU and 18.3%±2.5% with oral-BU (P= 51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia.
KW - Acute leukemia
KW - Busulfan
KW - Children
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U2 - 10.1016/j.bbmt.2013.09.012
DO - 10.1016/j.bbmt.2013.09.012
M3 - Article
C2 - 24071595
AN - SCOPUS:84887555975
SN - 1083-8791
VL - 19
SP - 1690
EP - 1694
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 12
ER -