Busulfan and cyclophosphamide as a preparative regimen for allogeneic blood and marrow transplantation in patients with non-Hodgkin's lymphoma

Bone Marrow Transplant. 2003 Jan;31(2):73-8. doi: 10.1038/sj.bmt.1703790.

Abstract

This study reports on overall and recurrence-free survival (OS and RFS) of 37 consecutive patients with low- and intermediate-grade NHL receiving a related donor allogeneic BMT using a nonradiation-containing preparative regimen. In addition, transplant-related toxicity and factors influencing outcome are discussed. The preparative regimen consisted of busulfan and cyclophosphamide. Median patient age was 44 years (range 20-55). In all, 18 were female. Median follow-up of surviving patients from BMT was 4.2 years. A total of 25 patients had low-grade, and 12 intermediate grade NHL. Most patients (89%) were treated with at least two different chemotherapy regimens prior to BMT. In all, 22 patients (59%) were transplanted in partial remission, 15 (41%) in complete remission. OS at 12 months was 89% (95% confidence interval (CI) of 79-99%) and 79% (64-93%) at 60 months. RFS at 12 months was 86% (75-97%) and at 5 years 70% (54-86%). Four patients (11%) relapsed. Seven patients (19%) died, six because of treatment-related toxicity and one with relapse. Univariate analysis showed improved OS for younger patients and patients of female gender, suggesting that allogeneic BMT using busulfan-cyclophosphamide as a preparative regimen can achieve disease control and possibly cure patients with NHL particularly younger ones.

MeSH terms

  • Adult
  • Bone Marrow Transplantation* / adverse effects
  • Busulfan / therapeutic use*
  • Cyclophosphamide / therapeutic use*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Graft vs Host Disease / epidemiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lymphoma, Non-Hodgkin / mortality
  • Lymphoma, Non-Hodgkin / pathology
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Stem Cell Transplantation* / adverse effects
  • Survival Analysis
  • Time Factors
  • Transplantation Conditioning / methods*
  • Transplantation, Autologous
  • Transplantation, Homologous

Substances

  • Immunosuppressive Agents
  • Cyclophosphamide
  • Busulfan