Zhang Guo-Cai, Zheng Dong, Guan Xun-Xing, Luo Shao-Kai, Li Juan, Peng Ai-Hua, Tong Xiu-Zhen, Lai Feng-Zhen, Tan En-Xun, Hong Wen-De
Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
Ai Zheng. 2003 Jun;22(6):620-3.
BACKGROUND & OBJECTIVE: The conditioning regimens are the critical factors in the allogeneic hematopoietic stem cell transplantation. This study was conducted to compare the effectiveness and side-effects of two conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT).
Twenty-one cases received busulfan(BU) 16 mg/kg plus cyclophosphamide(CY) 120 mg/kg,the other 23 cases received total body irradiation(TBI) 7.5-8.5 Gy plus CY 120 mg/kg regimen.
The 3-year disease-free survivals (DFS) were 61.5% in BU/CY group and 64.7% in TBI/CY group, respectively (P >0.05). The relapse rates were 23.8% and 26%, respectively, without significant difference (P >0.05). The incidence of liver damage in the BU/CY group was higher (80.9%) than that in the TBI/CY group (54.3%) (P< 0.05), while no case developed hepatic veno-occlusive disease. Stomatitis and gastrointestinal toxicity were significantly lower in the BU/CY group (33.3% and 42.9%) compared with TBI/CY group (78.2% and 78.2%), respectively (P< 0.05). Bladder toxicity (23.8% and 26%) and pulmonary toxicity(14.3% and 13%) were similar in the two groups(P >0.05), while one patient in TBI/CY group developed grade IV pulmonary toxicity, which is lethal. No case was found to have cardiac, renal, or central nervous system grade I toxicity.
The two groups have equal effectiveness, BU/CY regimen is relatively easy to administer and well tolerated with low extramedullary toxicity.
预处理方案是异基因造血干细胞移植中的关键因素。本研究旨在比较两种预处理方案在异基因造血干细胞移植（allo-HSCT）中的有效性和副作用。
21例患者接受白消安（BU）16mg/kg加环磷酰胺（CY）120mg/kg方案，另外23例患者接受全身照射（TBI）7.5 - 8.5Gy加CY 120mg/kg方案。
BU/CY组和TBI/CY组的3年无病生存率（DFS）分别为61.5%和64.7%（P>0.05）。复发率分别为23.8%和26%，无显著差异（P>0.05）。BU/CY组肝损伤发生率（80.9%）高于TBI/CY组（54.3%）（P<0.05），但两组均未发生肝静脉闭塞病。与TBI/CY组（分别为78.2%和78.2%）相比，BU/CY组口腔炎和胃肠道毒性显著更低（分别为33.3%和42.9%）（P<0.05）。两组膀胱毒性（23.8%和26%）和肺部毒性（14.3%和13%）相似（P>0.05），但TBI/CY组有1例患者发生IV级肺部毒性，为致死性。未发现有心脏、肾脏或中枢神经系统I级毒性的病例。
两组疗效相当，BU/CY方案给药相对简便，耐受性良好，髓外毒性低。
