Hematopoietic cell transplant in pediatric acute myeloid leukemia after similar upfront therapy; a comparison of conditioning regimens Journal Article


Authors: Versluys, A. B.; Boelens, J. J.; Pronk, C.; Lankester, A.; Bordon, V.; Buechner, J.; Ifversen, M.; Jackmann, N.; Sundin, M.; Vettenranta, K.; Abrahamsson, J.; Mellgren, K.
Article Title: Hematopoietic cell transplant in pediatric acute myeloid leukemia after similar upfront therapy; a comparison of conditioning regimens
Abstract: The impact of conditioning regimen prior to hematopoietic cell transplant (HCT) in pediatric AML-patients is not well studied. We retrospectively analyzed the impact of Busulfan–Cyclophosphamide (BuCy), Busulfan–Cyclophosphamide–Melphalan (BuCyMel) and Clofarabine–Fludarabine–Busulfan (CloFluBu) in pediatric AML-patients, with similar upfront leukemia treatment (NOPHO-DBHconsortium), receiving an HCT between 2010 and 2015. Outcomes of interest were LFS, relapse, TRM and GvHD. 103 patients were included; 30 received BuCy, 37 BuCyMel, and 36 CloFluBu. The 5-years LFS was 43.3% (SE ± 9.0) in the BuCy group, 59.2 % (SE ± 8.1) after BuCyMel, and 66.7 % (SE ± 7.9) after CloFluBu. Multivariable Cox regression analysis showed a trend to lower LFS after BuCy compared to CloFluBu (p = 0.07). BuCy was associated with a higher relapse incidence compared to the other regimens (p = 0.06). Younger age was a predictor for relapse (p = 0.02). A strong correlation between Busulfan Therapeutic Drug Monitoring (TDM) and lower incidence of aGvHD (p < 0.001) was found. In conclusion, LFS after BuCyMel and CloFluBu was comparable, lower LFS was found after BuCy, due to higher relapse incidence. CloFluBu was associated with lower incidence of aGvHD, suggesting lower toxicity with this type of conditioning. This finding is also explained by the impact of Busulfan monitoring. © 2021, The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature.
Journal Title: Bone Marrow Transplantation
Volume: 56
Issue: 6
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2021-06-01
Start Page: 1426
End Page: 1432
Language: English
DOI: 10.1038/s41409-020-01201-w
PUBMED: 33469191
PROVIDER: scopus
DOI/URL:
Notes: Article -- Correction issued, see DOI 10.1038/s41409-021-01257-2 -- Export Date: 1 July 2021 -- Source: Scopus
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  1. Jaap Jan Boelens
    97 Boelens