Cargando…

Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation

Allogeneic hematopoietic cell transplantation (HCT) offers a possible cure for patients with relapsed and refractory non-Hodgkin lymphoma (NHL) through potentially beneficial graft versus lymphoma effects. However, allogeneic HCT is associated with high nonrelapse mortality (NRM). Fludarabine with r...

Descripción completa

Detalles Bibliográficos
Autores principales: Kamijo, Kimimori, Shimomura, Yoshimitsu, Shinohara, Akihito, Mizuno, Shohei, Kanaya, Minoru, Usui, Yoshiaki, Kim, Sung-Won, Ara, Takahide, Mizuno, Ishikazu, Kuriyama, Takuro, Nakazawa, Hideyuki, Matsuoka, Ken-ichi, Kusumoto, Shigeru, Maseki, Nobuo, Yamaguchi, Masaki, Ashida, Takashi, Onizuka, Makoto, Fukuda, Takahiro, Atsuta, Yoshiko, Kondo, Eisei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977852/
https://www.ncbi.nlm.nih.gov/pubmed/36631705
http://dx.doi.org/10.1007/s00277-023-05084-x
_version_ 1784899385682821120
author Kamijo, Kimimori
Shimomura, Yoshimitsu
Shinohara, Akihito
Mizuno, Shohei
Kanaya, Minoru
Usui, Yoshiaki
Kim, Sung-Won
Ara, Takahide
Mizuno, Ishikazu
Kuriyama, Takuro
Nakazawa, Hideyuki
Matsuoka, Ken-ichi
Kusumoto, Shigeru
Maseki, Nobuo
Yamaguchi, Masaki
Ashida, Takashi
Onizuka, Makoto
Fukuda, Takahiro
Atsuta, Yoshiko
Kondo, Eisei
author_facet Kamijo, Kimimori
Shimomura, Yoshimitsu
Shinohara, Akihito
Mizuno, Shohei
Kanaya, Minoru
Usui, Yoshiaki
Kim, Sung-Won
Ara, Takahide
Mizuno, Ishikazu
Kuriyama, Takuro
Nakazawa, Hideyuki
Matsuoka, Ken-ichi
Kusumoto, Shigeru
Maseki, Nobuo
Yamaguchi, Masaki
Ashida, Takashi
Onizuka, Makoto
Fukuda, Takahiro
Atsuta, Yoshiko
Kondo, Eisei
author_sort Kamijo, Kimimori
collection PubMed
description Allogeneic hematopoietic cell transplantation (HCT) offers a possible cure for patients with relapsed and refractory non-Hodgkin lymphoma (NHL) through potentially beneficial graft versus lymphoma effects. However, allogeneic HCT is associated with high nonrelapse mortality (NRM). Fludarabine with reduced-intensity busulfan (Flu/Bu2) and myeloablative busulfan (Flu/Bu4) are commonly used in conditioning regimens for allogeneic HCT; however, data on their use in patients with NHL is limited. We investigated the effect of busulfan dose on outcomes by comparing Flu/Bu2 and Flu/Bu4 in patients with NHL who underwent allogeneic HCT. Our study included 415 adult patients with NHL who received Flu/Bu2 (315 patients) or Flu/Bu4 (100 patients) between January 2008 and December 2019. All patients were enrolled in the Transplant Registry Unified Management Program 2 of the Japanese Data Center for Hematopoietic Cell Transplantation. The primary endpoint was the 5-year overall survival (OS). To minimize potential confounding factors that may influence outcomes, we performed propensity score matching. The 5-year OS was 50.6% (95% confidence interval (CI), 39.4%–60.8%) and 32.2% (95% CI, 22.4–42.4%) in the Flu/Bu2 and Flu/Bu4 groups, respectively (p = 0.006). The hazard ratio comparing the two groups was 2.13 (95% CI, 1.30–3.50; p = 0.003). Both groups had a similar 5-year cumulative incidence of relapse (38.2% vs 41.3%; p = 0.581), and the Flu/Bu4 group had a higher cumulative incidence of 5-year NRM (15.7% vs 31.9%; p = 0.043). In this study, Flu/Bu4 was associated with worse OS compared with Flu/Bu2 because of high NRM in patients with NHL. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-023-05084-x.
format Online
Article
Text
id pubmed-9977852
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-99778522023-03-03 Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation Kamijo, Kimimori Shimomura, Yoshimitsu Shinohara, Akihito Mizuno, Shohei Kanaya, Minoru Usui, Yoshiaki Kim, Sung-Won Ara, Takahide Mizuno, Ishikazu Kuriyama, Takuro Nakazawa, Hideyuki Matsuoka, Ken-ichi Kusumoto, Shigeru Maseki, Nobuo Yamaguchi, Masaki Ashida, Takashi Onizuka, Makoto Fukuda, Takahiro Atsuta, Yoshiko Kondo, Eisei Ann Hematol Original Article Allogeneic hematopoietic cell transplantation (HCT) offers a possible cure for patients with relapsed and refractory non-Hodgkin lymphoma (NHL) through potentially beneficial graft versus lymphoma effects. However, allogeneic HCT is associated with high nonrelapse mortality (NRM). Fludarabine with reduced-intensity busulfan (Flu/Bu2) and myeloablative busulfan (Flu/Bu4) are commonly used in conditioning regimens for allogeneic HCT; however, data on their use in patients with NHL is limited. We investigated the effect of busulfan dose on outcomes by comparing Flu/Bu2 and Flu/Bu4 in patients with NHL who underwent allogeneic HCT. Our study included 415 adult patients with NHL who received Flu/Bu2 (315 patients) or Flu/Bu4 (100 patients) between January 2008 and December 2019. All patients were enrolled in the Transplant Registry Unified Management Program 2 of the Japanese Data Center for Hematopoietic Cell Transplantation. The primary endpoint was the 5-year overall survival (OS). To minimize potential confounding factors that may influence outcomes, we performed propensity score matching. The 5-year OS was 50.6% (95% confidence interval (CI), 39.4%–60.8%) and 32.2% (95% CI, 22.4–42.4%) in the Flu/Bu2 and Flu/Bu4 groups, respectively (p = 0.006). The hazard ratio comparing the two groups was 2.13 (95% CI, 1.30–3.50; p = 0.003). Both groups had a similar 5-year cumulative incidence of relapse (38.2% vs 41.3%; p = 0.581), and the Flu/Bu4 group had a higher cumulative incidence of 5-year NRM (15.7% vs 31.9%; p = 0.043). In this study, Flu/Bu4 was associated with worse OS compared with Flu/Bu2 because of high NRM in patients with NHL. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00277-023-05084-x. Springer Berlin Heidelberg 2023-01-12 2023 /pmc/articles/PMC9977852/ /pubmed/36631705 http://dx.doi.org/10.1007/s00277-023-05084-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Kamijo, Kimimori
Shimomura, Yoshimitsu
Shinohara, Akihito
Mizuno, Shohei
Kanaya, Minoru
Usui, Yoshiaki
Kim, Sung-Won
Ara, Takahide
Mizuno, Ishikazu
Kuriyama, Takuro
Nakazawa, Hideyuki
Matsuoka, Ken-ichi
Kusumoto, Shigeru
Maseki, Nobuo
Yamaguchi, Masaki
Ashida, Takashi
Onizuka, Makoto
Fukuda, Takahiro
Atsuta, Yoshiko
Kondo, Eisei
Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
title Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
title_full Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
title_fullStr Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
title_full_unstemmed Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
title_short Fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-Hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
title_sort fludarabine plus reduced-intensity busulfan versus fludarabine plus myeloablative busulfan in patients with non-hodgkin lymphoma undergoing allogeneic hematopoietic cell transplantation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977852/
https://www.ncbi.nlm.nih.gov/pubmed/36631705
http://dx.doi.org/10.1007/s00277-023-05084-x
work_keys_str_mv AT kamijokimimori fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT shimomurayoshimitsu fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT shinoharaakihito fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT mizunoshohei fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT kanayaminoru fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT usuiyoshiaki fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT kimsungwon fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT aratakahide fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT mizunoishikazu fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT kuriyamatakuro fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT nakazawahideyuki fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT matsuokakenichi fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT kusumotoshigeru fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT masekinobuo fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT yamaguchimasaki fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT ashidatakashi fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT onizukamakoto fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT fukudatakahiro fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT atsutayoshiko fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation
AT kondoeisei fludarabineplusreducedintensitybusulfanversusfludarabineplusmyeloablativebusulfaninpatientswithnonhodgkinlymphomaundergoingallogeneichematopoieticcelltransplantation