Database : MEDLINE
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[PMID]: 29523884
[Au] Autor:Augeul-Meunier K; Chretien ML; Stoppa AM; Karlin L; Benboubker L; Diaz JMT; Mohty M; Yakoub-Agha I; Bay JO; Perrot A; Bulabois CE; Huynh A; Mercier M; Frenzel L; Avet-Loiseau H; de Latour RP; Cornillon J
[Ad] Address:Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France.
[Ti] Title:Extending autologous transplantation as first line therapy in multiple myeloma patients with severe renal impairment: a retrospective study by the SFGM-TC.
[So] Source:Bone Marrow Transplant;, 2018 Mar 09.
[Is] ISSN:1476-5365
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Renal impairment is a common complication of multiple myeloma (MM), accounting for 20-30% of MM patients at diagnosis and 40-50% of patients during the course of their disease. This feature is associated with poor prognosis and shorter survival as compared to patients with normal renal function (NRF). Therefore, therapeutic management is challenging as autologous stem cell transplantation (ASCT) is often not considered as a valuable strategy, mainly due to concerns of toxicity. In this retrospective and multicenter study, we included 55 MM patients with dialysis-dependent or independent renal failure who underwent high-dose melphalan-based ASCT in order to assess the efficacy outcomes and toxicities of this strategy. Response to ASCT was at least VGPR (very good PR) in 58% of patients and 96% of patients who also received bortezomib-based induction were at least in PR after ASCT. Median OS was 76 months and median PFS was 55 months, similarly to MM patients with NRF. In multivariate analysis, dose of melphalan (140 mg/m ) was correlated with better PFS (18 months, P = 0.005). Toxicities included febrile neutropenia (75%) and severe mucositis (34%). Overall, this work confirmed that ASCT conditioned by 140 mg/m melphalan is a beneficial procedure for MM patients with renal failure.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1038/s41409-018-0122-8

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[PMID]: 29521131
[Au] Autor:Ramírez-Arroniz JC; Martínez Klimova E; Pedro-Hernández LD; Organista-Mateos U; Cortez-Maya S; Ramírez-Ápan T; Nieto-Camacho A; Calderón-Pardo J; Martínez-García M
[Ad] Address:a Instituto de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria , Circuito Exterior, Coyoacán C.P. 04510 , México D.F. , México.
[Ti] Title:Water-Soluble Porphyrin-PAMAM-Conjugates of Melphalan and Their Anticancer Activity.
[So] Source:Drug Dev Ind Pharm;:1-21, 2018 Mar 09.
[Is] ISSN:1520-5762
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Melphalan is an approved anti-cancer agent with a broad spectrum of antitumor activity. However, it has some disadvantages, such as poor water-solubility followed by rapid elimination, which reduce the target specificity. To solve these problems, porphyrin-PAMAM-conjugates of melphalan were synthesized and characterized. The dendrimeric conjugates showed satisfactory water solubility. It was found that the size of the dendrimer played a crucial role in controlling the drug content and diameter of the melphalan-conjugates. The in vitro studies of cell cytotoxicity revealed that by employing the dendrimeric conjugation strategy and using the poly(amidoamine) (PAMAM) dendritic arms as spacers, the conjugates had good anti-cancer activity and lower toxicity than free melphalan.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1080/03639045.2018.1449857

  3 / 9841 MEDLINE  
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[PMID]: 29476021
[Au] Autor:Chahoud J; Sui D; Erwin WD; Gulbis AM; Korbling M; Zhang M; Ahmed S; Alatrash G; Anderlini P; Ciurea SO; Oran B; Fayad L; Bassett RL; Jabbour E; Medeiros LJ; Macapinlac HA; Young KH; Khouri IF
[Ad] Address:Cancer Medicine, The University of Texas MD Anderson Cancer Center.
[Ti] Title:Updated Results of Rituximab Pre- and Post-BEAM with or without 90Yttrium-Ibritumomab Tiuxetan during Autologous Transplant for Diffuse Large B-Cell Lymphoma.
[So] Source:Clin Cancer Res;, 2018 Feb 23.
[Is] ISSN:1078-0432
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: We evaluated the effect on long-term survival of adding rituximab (R) to BEAM (carmustine, etoposide, cytarabine, and melphalan) conditioning with or without yttrium-90 ibritumomab tiuxetan (90YIT) in patients with relapsed diffuse large B-cell lymphoma (DLBCL) undergoing autologous stem cell transplant (ASCT). EXPERIMENTAL DESIGN: Patients were enrolled on three consecutive phase 2 clinical trials. Patients received two doses of rituximab (375 mg/m2 and 1000 mg/m2) during mobilization of stem cells, followed by 1000 mg/m2 on days +1 and +8 after ASCT with R-BEAM or 90YIT-R-BEAM (90YIT dose of 0.4 mCi/kg) conditioning.  Results: One hundred thirteen patients were enrolled, with 73 receiving R-BEAM and 40 receiving 90YIT-R-BEAM. All patients had a prior exposure to rituximab. The median follow-up intervals for survivors were 11.8, 8.1, and 4.2 years in the three trials, respectively. The 5-year disease-free survival (DFS) rates were 62% for R-BEAM and 65% for 90YIT-R-BEAM (P =0.82). The 5-year overall survival rates were 73%, and 77%, respectively (P = 0.65). In patients with de novo DLBCL, survival outcomes of the germinal center/activated b-cell histologic subtypes were similar with 5-year OS rates (P = 0.52) and DFS rates (P = 0.64), irrespective of their time of relapse (< vs. > 1 year) after initial induction chemotherapy (P = 0.97).   Conclusions:Administering ASCT with rituximab during stem cell collection and immediately after transplantation induces long-term disease remission and abolishes the negative prognostic impact of cell-of-origin in patients with relapsed DLBCL. The addition of 90YIT does not confer a further survival benefit.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 9841 MEDLINE  
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[PMID]: 29302684
[Au] Autor:Dhakal B; Szabo A; Chhabra S; Hamadani M; D'Souza A; Usmani SZ; Sieracki R; Gyawali B; Jackson JL; Asimakopoulos F; Hari PN
[Ad] Address:Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee.
[Ti] Title:Autologous Transplantation for Newly Diagnosed Multiple Myeloma in the Era of Novel Agent Induction: A Systematic Review and Meta-analysis.
[So] Source:JAMA Oncol;4(3):343-350, 2018 Mar 01.
[Is] ISSN:2374-2445
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: The role of high-dose therapy with melphalan followed by autologous stem cell transplant (HDT/ASCT) in patients with multiple myeloma continues to be debated in the context of novel agent induction. Objective: To perform a systematic review, conventional meta-analysis, and network meta-analysis of all phase 3 randomized clinical trials (RCTs) evaluating the role of HDT/ASCT. Data Sources: We performed a systematic literature search of Cochrane Central, MEDLINE, and Scopus from January 2000 through April 2017 and relevant annual meeting abstracts from January 2014 to December 2016. The following search terms were used: "myeloma" combined with "autologous," "transplant," "myeloablative," or "stem cell." Study Selection: Phase 3 RCTs comparing HDT/ASCT with standard-dose therapy (SDT) using novel agents were assessed. Studies comparing single HDT/ASCT with bortezomib, lenalidomide, and dexamethasone consolidation and tandem transplantation were included for network meta-analysis. Data Extraction And Synthesis: For the random effects meta-analysis, we used hazard ratios (HRs) and corresponding 95% CIs. Main Outcomes and Measures: The primary outcome was progression-free survival (PFS). Overall survival (OS), complete response, and treatment-related mortality were secondary outcomes. Results: A total of 4 RCTs (2421 patients) for conventional meta-analysis and 5 RCTs (3171 patients) for network meta-analysis were selected. The combined odds for complete response were 1.27 (95% CI, 0.97-1.65; P = .07) with HDT/ASCT when compared with SDT. The combined HR for PFS was 0.55 (95% CI, 0.41-0.74; P < .001) and 0.76 for OS (95% CI, 0.42-1.36; P = .20) in favor of HDT. Meta-regression showed that longer follow-up was associated with superior PFS (HR/mo, 0.98; 95% CI, 0.96-0.99; P = .03) and OS (HR/mo, 0.90; 95% CI, 0.84-0.96; P = .002). For PFS, tandem HDT/ASCT had the most favorable HR (0.49; 95% CI, 0.37-0.65) followed by single HDT/ASCT with bortezomib, lenalidomide, and dexamethasone (HR, 0.53; 95% CI, 0.37-0.76) and single HDT/ASCT alone (HR, 0.68; 95% CI, 0.53-0.87) compared with SDT. For OS, none of the HDT/ASCT-based approaches had a significant effect on survival. Treatment-related mortality with HDT/ASCT was minimal (<1%). Conclusions and Relevance: The results of the conventional meta-analysis and network meta-analysis of all the phase 3 RCTs showed that HDT/ASCT was associated with superior PFS with minimal toxic effects compared with SDT. Both tandem HDT/ASCT and single HDT/ASCT with bortezomib, lenalidomide, and dexamethasone were superior to single HDT/ASCT alone and SDT for PFS, but OS was similar across the 4 approaches. Longer follow-up may better delineate any OS benefit; however, is likely to be affected by effective postrelapse therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1001/jamaoncol.2017.4600

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[PMID]: 29516970
[Au] Autor:Hua J; Gang S; Yizhou J; Jing Z
[Ad] Address:Jinan University, Guangzhou, Guangdong, Department of Interventional Radiology and Vascular Anomalies Guangzhou Women and Children's Medical Center, Guangzhou, China.
[Ti] Title:Intra-arterial chemotherapy as second-line treatment for advanced retinoblastoma: A 2-year single-center study in China.
[So] Source:J Cancer Res Ther;14(1):106-110, 2018 Jan.
[Is] ISSN:1998-4138
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Purpose: To evaluate the effectiveness and complications of intra-arterial chemotherapy (IAC) for treating advanced refractory retinoblastoma (RB) in a large single-center cohort. Patients and Methods: Eighty-four eyes of 62 consecutive patients with advanced refractory RB who received IAC were included in the study during January 2013 and April 2015. These patients failed to respond adequately to a standard systemic chemotherapy (i.e., carboplatin, vincristine, and etoposide) with or without local therapy. Clinical outcomes and complications of these patients were reviewed. Results: All of these patients received IAC of melphalan combined with topotecan. The mean follow-up period was 14.2 months after final IAC (ranged from 3 to 28 months). The rate of eye preservation was 41.67% in Group D and 20.83% in Group E of this study. Short-term ocular adverse events included eyelid edema (n = 12, 14.29%), bulbar conjunctiva congestion (n = 25, 29.76%), and excessive tearing (n = 10, 11.90%). Long-term complications included vitreous hemorrhage (n = 7, 8%), subretinal hemorrhage (n = 9, 11%), retinal vasculopathy (n = 6, 7%), and ophthalmic artery spasm with reperfusion (n = 11, 13%). Fever was observed after IAC in 14 patients; transient vomiting was observed in 17 patients; there were 8 cases of transient myelosuppression. Conclusion: IAC can be an optional treatment to save eyes of Group D RB that failed in systemic chemotherapy and were destined for enucleation. However, it should be cautioned for Group E. Both the ocular and systemic toxicities of IAC were within tolerance.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.4103/jcrt.JCRT_722_17

  6 / 9841 MEDLINE  
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[PMID]: 29514706
[Au] Autor:Striha A; Ashcroft AJ; Hockaday A; Cairns DA; Boardman K; Jacques G; Williams C; Snowden JA; Garg M; Cavenagh J; Yong K; Drayson MT; Owen R; Cook M; Cook G
[Ad] Address:Clinical Trials Research Unit (CTRU), Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
[Ti] Title:The role of ixazomib as an augmented conditioning therapy in salvage autologous stem cell transplant (ASCT) and as a post-ASCT consolidation and maintenance strategy in patients with relapsed multiple myeloma (ACCoRd [UK-MRA Myeloma XII] trial): study protocol for a Phase III randomised controlled trial.
[So] Source:Trials;19(1):169, 2018 Mar 07.
[Is] ISSN:1745-6215
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Multiple myeloma (MM) is a plasma cell tumour with an approximate annual incidence of 4500 in the UK. Therapeutic options for patients with MM have changed in the last decade with the arrival of proteasome inhibitors and immunomodulatory drugs. Despite these options, almost all patients will relapse post first-line autologous stem cell transplantation (ASCT). First relapse management (second-line treatment) has evolved in recent years with an expanding portfolio of novel agents, driving response rates influencing the durability of response. A second ASCT, as part of relapsed disease management (salvage ASCT), has been shown to prolong the progression-free survival and overall survival following a proteasome inhibitor-containing re-induction regimen, in the Cancer Research UK-funded National Cancer Research Institute Myeloma X (Intensive) study. It is now recommended that salvage ASCT be considered for suitable patients by the International Myeloma Working Group and the National Institute for Health and Care Excellence NG35 guidance. METHODS/DESIGN: ACCoRd (Myeloma XII) is a UK-nationwide, individually randomised, multi-centre, multiple randomisation, open-label phase III trial with an initial single intervention registration phase aimed at relapsing MM patients who have received ASCT in first-line treatment. We will register 406 participants into the trial to allow 284 and 248 participants to be randomised at the first and second randomisations, respectively. All participants will receive re-induction therapy until maximal response (four to six cycles of ixazomib, thalidomide and dexamethasone). Participants who achieve at least stable disease will be randomised (1:1) to receive either ASCT , using high-dose melphalan, or ASCT , using high-dose melphalan with ixazomib. All participants achieving or maintaining a minimal response or better, following salvage ASCT, will undergo a second randomisation (1:1) to consolidation and maintenance or observation. Participants randomised to consolidation and maintenance will receive consolidation with two cycles of ixazomib, thalidomide and dexamethasone, and maintenance with ixazomib until disease progression. DISCUSSION: The question of how best to maximise the durability of response to salvage ASCT warrants clinical investigation. Given the expanding scope of oral therapeutic agents, patient engagement with long-term maintenance strategies is a real opportunity. This study will provide evidence to better define post-relapse treatment in MM. TRIAL REGISTRATION: ISRCTN, ISRCTN10038996 . Registered on 15 December 2016.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1186/s13063-018-2524-8

  7 / 9841 MEDLINE  
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[PMID]: 29177308
[Au] Autor:Fang K; Wu S; Dong G; Wu Y; Chen S; Liu J; Wang W; Sheng C
[Ad] Address:School of Pharmacy, East China University of Science and Technology, Shanghai 200237, P. R. China. wwang@unm.edu.
[Ti] Title:Discovery of IDO1 and DNA dual targeting antitumor agents.
[So] Source:Org Biomol Chem;15(47):9992-9995, 2017 Dec 06.
[Is] ISSN:1477-0539
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The development of small molecules for cancer immunotherapy is highly challenging and indoleamine 2,3-dioxygenase 1 (IDO1) represents a promising target. Inspired by the synergistic effects between IDO1 inhibitors and traditional antitumor chemotherapeutics, the first orally active dual IDO1 and DNA targeting agents were designed by the pharmacophore fusion strategy. The bifunctional hybrids exhibited enhanced IDO1 enzyme inhibitory activity and in vitro cytotoxicity as compared to IDO1 inhibitor 1-methyl-tryptophan and DNA alkylating agent melphalan. In a murine LLC tumor model, the dual targeting agents demonstrated excellent antitumor efficacy, highlighting the advantages of this novel design strategy to improve the efficacy of small molecule cancer immunotherapy.
[Mh] MeSH terms primary: Antineoplastic Agents/pharmacology
DNA, Neoplasm/drug effects
Enzyme Inhibitors/pharmacology
Indoleamine-Pyrrole 2,3,-Dioxygenase/antagonists & inhibitors
Melphalan/pharmacology
Tryptophan/analogs & derivatives
[Mh] MeSH terms secundary: Animals
Antineoplastic Agents/chemical synthesis
Antineoplastic Agents/chemistry
Cell Line, Tumor
Cell Proliferation/drug effects
Dose-Response Relationship, Drug
Drug Discovery
Drug Screening Assays, Antitumor
Enzyme Inhibitors/chemical synthesis
Enzyme Inhibitors/chemistry
Humans
Immunotherapy
Indoleamine-Pyrrole 2,3,-Dioxygenase/metabolism
Melphalan/chemical synthesis
Melphalan/chemistry
Mice
Molecular Structure
Neoplasms, Experimental/drug therapy
Structure-Activity Relationship
Tryptophan/chemical synthesis
Tryptophan/chemistry
Tryptophan/pharmacology
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (1-methyltryptophan); 0 (Antineoplastic Agents); 0 (DNA, Neoplasm); 0 (Enzyme Inhibitors); 0 (Indoleamine-Pyrrole 2,3,-Dioxygenase); 0 (indoleamine 2,3-dioxygenase 1, human); 8DUH1N11BX (Tryptophan); Q41OR9510P (Melphalan)
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Js] Journal subset:IM
[Da] Date of entry for processing:171128
[St] Status:MEDLINE
[do] DOI:10.1039/c7ob02529g

  8 / 9841 MEDLINE  
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[PMID]: 29157615
[Au] Autor:Jaccard A
[Ad] Address:Department of Clinical Hematology, Reference Center for AL Amyloidosis, CHU, 2 Avenue ML King, Limoges 87000, France. Electronic address: arnaud.jaccard@chu-limoges.fr.
[Ti] Title:POEMS Syndrome: Therapeutic Options.
[So] Source:Hematol Oncol Clin North Am;32(1):141-151, 2018 02.
[Is] ISSN:1558-1977
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Treatment of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome should be directed at the underlying plasma cell clone with risk-adapted therapy based on the extent of the plasma cell disorder. Radiation therapy is effective for patients with a localized presentation, without bone marrow involvement, and 1 to 3 bone lesions. Patients with disseminated disease should receive, preferably, high-dose chemotherapy with peripheral blood transplantation. Low-dose melphalan and dexamethasone or new agents used in myeloma are also effective. The most promising agent is lenalidomide, which could be given before high-dose therapy or radiation to get rapid neurologic responses.
[Mh] MeSH terms primary: POEMS Syndrome/therapy
Peripheral Blood Stem Cell Transplantation
Thalidomide/analogs & derivatives
[Mh] MeSH terms secundary: Allografts
Humans
POEMS Syndrome/diagnosis
POEMS Syndrome/pathology
Radiotherapy
Thalidomide/therapeutic use
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:4Z8R6ORS6L (Thalidomide); F0P408N6V4 (lenalidomide)
[Em] Entry month:1801
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[Js] Journal subset:IM
[Da] Date of entry for processing:171122
[St] Status:MEDLINE

  9 / 9841 MEDLINE  
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[PMID]: 29513055
[Au] Autor:Abramson DH; Catalanotti F; Brodie SE; Kellick MG; Francis JH
[Ad] Address:a Department of Surgery , Memorial Sloan Kettering Cancer Center , New York , NY , USA.
[Ti] Title:Intravitreal chemotherapy and laser for newly visible subretinal seeds in retinoblastoma.
[So] Source:Ophthalmic Genet;:1-4, 2018 Mar 07.
[Is] ISSN:1744-5094
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: There has been no effective method for treating newly visible ("new") subretinal seeding in retinoblastoma except enucleation. The objective of this report is to determine whether intravitreal chemotherapy combined with 810 nm indirect laser can successfully treat retinoblastoma eyes with "new" subretinal seeding which appeared after intra-arterial chemotherapy (ophthalmic arterial chemosurgery: OAC). MATERIAL AND METHODS: Single center retrospective study from a tertiary cancer hospital of a case series of 14 eyes treated with combined intravitreal chemotherapy and laser from 2012 to 2017. Ocular salvage, patient survival, recurrence-free ocular survival, metastases, and extraocular extension were assessed. RESULTS: A total of 14 eyes in 13 unilateral or bilateral retinoblastoma patients with "new" subretinal seeding after initial eye salvage therapy were treated with combined intravitreal injection of melphalan (30 ug) or melphalan (30 ug) and topotecan (20 ug) and with 810 nm indirect continuous wave laser. All eyes were salvaged. Only two eyes (14%) recurred again for subretinal seeds after 6 and 8 months, respectively, and required additional cycles of intravitreal injections and laser. Combined intravitreal injection of melphalan or melphalan plus topotecan with 810 nm indirect continuous wave laser was not associated with any metastatic events, patient deaths, extraocular extension, or need for enucleation. CONCLUSION: There has been no effective treatment for "new" subretinal seeding after OAC except enucleation or second course OAC. Combined intravitreal chemotherapy with 810 nm indirect laser may be an effective and safe alternative to enucleation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1080/13816810.2018.1443343

  10 / 9841 MEDLINE  
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[PMID]: 29197676
[Au] Autor:Kebriaei P; Anasetti C; Zhang MJ; Wang HL; Aldoss I; de Lima M; Khoury HJ; Sandmaier BM; Horowitz MM; Artz A; Bejanyan N; Ciurea S; Lazarus HM; Gale RP; Litzow M; Bredeson C; Seftel MD; Pulsipher MA; Boelens JJ; Alvarnas J; Champlin R; Forman S; Pullarkat V; Weisdorf D; Marks DI; Acute Leukemia Committee of the CIBMTR
[Ad] Address:Department of Stem Cell Transplantation, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: pkebriaei@mdanderson.org.
[Ti] Title:Intravenous Busulfan Compared with Total Body Irradiation Pretransplant Conditioning for Adults with Acute Lymphoblastic Leukemia.
[So] Source:Biol Blood Marrow Transplant;, 2017 Dec 25.
[Is] ISSN:1523-6536
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Total body irradiation (TBI) has been included in standard conditioning for acute lymphoblastic leukemia (ALL) before hematopoietic cell transplantation (HCT). Non-TBI regimens have incorporated busulfan (Bu) to decrease toxicity. This retrospective study analyzed TBI and Bu on outcomes of ALL patients 18-60 years old, in first or second complete remission (CR), undergoing HLA-compatible sibling, related, or unrelated donor HCT, who reported to the Center for International Blood and Marrow Transplant Research from 2005 to 2014. TBI plus etoposide (25%) or cyclophosphamide (75%) was used in 819 patients, and intravenous Bu plus fludarabine (41%), clofarabine (30%), cyclophosphamide (15%), or melphalan (13%) was used in 299 patients. Bu-containing regimens were analyzed together, since no significant differences for patient outcomes were noted between them. Bu patients were older, with better performance status; took longer to achieve first CR and receive HCT; were treated more recently; and were more likely to receive peripheral blood grafts, antithymocyte globulin, or tyrosine kinase inhibitors. With median follow-up of 3.6 years for Bu and 5.3 years for TBI, adjusted 3-year outcomes showed treatment-related mortality Bu 19% versus TBI 25% (P = .04); relapse Bu 37% versus TBI 28% (P = .007); disease-free survival (DFS) Bu 45% versus TBI 48% (P = .35); and overall survival (OS) Bu 57% versus TBI 53% (P = .35). In multivariate analysis, Bu patients had higher risk of relapse (relative risk, 1.46; 95% confidence interval, 1.15 to 1.85; P = .002) compared with TBI patients. Despite the higher relapse, Bu-containing conditioning led to similar OS and DFS following HCT for ALL.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher


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