Intravenous BU plus Mel: an effective, chemotherapy-only transplant conditioning regimen in patients with ALL.


Journal Article

We investigated the administration of i.v. BU combined with melphalan (Mel) in patients with ALL undergoing allogeneic hematopoietic SCT. Forty-seven patients with a median age of 33 years (range 20-61) received a matched sibling (n=27) or matched unrelated donor transplant (n=20) for ALL in first CR (n=26), second CR (n=13), or with more advanced disease (n=8). BU was infused daily for 4 days, either at a fixed dose of 130 mg/m² (5 patients) or using pharmacokinetic (PK) dose adjustment (42 patients), to target an average daily area-under-the-curve (AUC) of 5000 μmol/min, determined by a test dose of i.v. BU at 32 mg/m². This was followed by a rest day, then two daily doses of Mel at 70 mg/m². Stem cells were infused on the following day. The 2-year OS, PFS and non-relapse mortality (NRM) rates were 35% (95% confidence interval (CI), 23-51%), 31% (95% CI, 21-48%) and 37% (95% CI, 23-50%), respectively. Acute NRM at 100 days was favorable at 12% (95% CI, 5-24%); however, the 2-year NRM was significantly higher for patients older than 40 years, 58% vs 20%, mainly due to GVHD.

Full Text

Duke Authors

Cited Authors

  • Kebriaei, P; Madden, T; Wang, X; Thall, PF; Ledesma, C; de Lima, M; Shpall, EJ; Hosing, C; Qazilbash, M; Popat, U; Alousi, A; Nieto, Y; Champlin, RE; Jones, RB; Andersson, BS

Published Date

  • January 2013

Published In

Volume / Issue

  • 48 / 1

Start / End Page

  • 26 - 31

PubMed ID

  • 22732703

Pubmed Central ID

  • 22732703

Electronic International Standard Serial Number (EISSN)

  • 1476-5365

Digital Object Identifier (DOI)

  • 10.1038/bmt.2012.114


  • eng

Conference Location

  • England