Reduced-intensity conditioning allogeneic hematopoietic cell transplantation using oral fludarabine as part of the conditioning regimen
| Autor: | Jordi Sierra, E. Moreno, Javier Briones, José Luis Piñana, Julio Delgado, Rodrigo Martino, A. Marco, Salut Brunet, Anna Sureda, David Valcárcel |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Oncology Melphalan Cancer Research medicine.medical_specialty Transplantation Conditioning Adolescent Survival Platelet Engraftment Immunology Administration Oral Graft vs Host Disease Conditioning regimen oral reduced intensity Internal medicine medicine Humans Transplantation Homologous Immunology and Allergy Genetics (clinical) Aged Bone Marrow Transplantation Retrospective Studies Transplantation allogeneic hematopoietic cell transplantation Neutrophil Engraftment business.industry Histocompatibility Testing fludarabine Retrospective cohort study Cell Biology Middle Aged Myeloablative Agonists Surgery Fludarabine Treatment Outcome Hematologic Neoplasms Injections Intravenous Female business Vidarabine Busulfan medicine.drug |
| Zdroj: | CYTOTHERAPY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| ISSN: | 1465-3249 |
| Popis: | Background In 2003, oral fludarabine was introduced for the treatment of patients with hematologic malignancies as an alternative to its intravenous (i.v.) formulation. In an attempt to simplify the management of patients undergoing reduced intensity allogeneic hematopoietic transplantation, we have incorporated oral fludarabine in the conditioning regimen. Methods We present a non-randomized retrospective analysis of 37 patients conditioned with oral fludarabine compared with 144 patients conditioned with the i.v. formulation. In addition to fludarabine, the conditioning regimens also included melphalan or busulfan depending on the underlying disease. Donors were HLA-matched siblings in 75% of cases and unrelated donors in the remaining 25%. Results Eight patients (22%) receiving oral fludarabine were switched to the i.v. route because of gastrointestinal toxicity (three patients), patient preference (two patients) and physician preference (three patients). There were no statistical differences in terms of hospital admission (P=0.16), time to neutrophil engraftment (P=0.35), time to platelet engraftment (P=0.38), acute graft versus host disease rate (P=0.71) and non-relapse mortality at days +30 (P=1.0) and +100 (P=0.43). Discussion This preliminary analysis confirms that oral fludarabine can replace its i.v. formulation as part of reduced-intensity conditioning regimens with no deleterious effect on any of the early transplantation outcomes. In addition, oral fludarabine can be more convenient for patients and caregivers, facilitating its implementation. |
| Databáze: | OpenAIRE |
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