Copelan E A, Biggs J C, Thompson J M, Crilley P, Szer J, Klein J P, Kapoor N, Avalos B R, Cunningham I, Atkinson K
Department of Internal Medicine, Ohio State University, Columbus.
Blood. 1991 Aug 1;78(3):838-43.
One hundred twenty-seven patients with acute myelocytic leukemia (AML) were given busulfan 4 mg/kg on each of 4 days and cyclophosphamide 60 mg/kg on each of 2 days (BuCy2) followed by allogeneic bone marrow transplantation from an HLA-identical or one antigen disparate sibling. For 71 patients in first complete remission, 23 in second complete remission or initial relapse, and 33 patients with primary refractory disease, second or subsequent relapse, or a preceding hematologic disorder, the 3-year leukemia-free survival (LFS) is 63.1%, 32.6%, and 24.2% respectively. The actuarial probability of relapse for each group is 14.1%, 40.6%, and 61.0%. In multivariate analyses, relapse and decreased LFS were associated with advanced disease phase and with M4/M5 French-American-British classification. The LFS of first remission patients was adversely associated with a short time interval from diagnosis to transplantation. This study indicates that BuCy2 is an attractive preparative regimen for marrow transplantation in patients with AML and that prognostic factors for relapse and LFS are similar those described for regimens containing total body irradiation.
127例急性髓细胞白血病（AML）患者接受白消安4mg/kg，连续4天，环磷酰胺60mg/kg，连续2天（BuCy2）的预处理，随后接受来自 HLA 相同或一个抗原不相合的同胞供者的异基因骨髓移植。对于71例首次完全缓解的患者、23例第二次完全缓解或初次复发的患者以及33例原发性难治性疾病、第二次或后续复发或既往有血液系统疾病的患者，3年无白血病生存率（LFS）分别为63.1%、32.6%和24.2%。每组的复发精算概率分别为14.1%、40.6%和61.0%。在多变量分析中，复发和LFS降低与疾病晚期以及M4/M5法国-美国-英国分类相关。首次缓解患者的LFS与从诊断到移植的时间间隔短呈负相关。本研究表明，BuCy2是AML患者骨髓移植的一种有吸引力的预处理方案，复发和LFS的预后因素与含全身照射的方案相似。
