Rasor Brendan, Dickerson Tyler, Zhao Qiuhong, Elder Patrick, Brammer Jonathan E, Larkin Karilyn, Jaglowski Samantha, Mims Alice, Penza Sam, Vasu Sumithira, Wall Sarah A, William Basem, Saad Ayman, Roddy Julianna V F, Choe Hannah, Puto Marcin
Department of Pharmacy, James Cancer Hospital, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Pharmacy, Kettering Health Network, Kettering, OH, USA.
Leuk Lymphoma. 2021 Apr;62(4):944-951. doi: 10.1080/10428194.2020.1849677. Epub 2020 Nov 24.
A retrospective cohort study was conducted to assess differences in efficacy and tolerability between a busulfan AUC target of 16.4 mg × Hr/L per day (FluBu4K) and a conventional RIC regimen (FluBu2). Adult patients with a diagnosis of AML or MDS who received fludarabine + busulfan conditioning with or without antithymocyte globulin between 2015 and 2018 were included. The primary outcome was relapse free survival. Overall, 74 patients received conditioning with either FluBu4K or FluBu2. At 18 months, relapse-free survival was not significantly different, at 63.9% with FluBu4k compared to 57.5% with FluBu2 ( = 0.49). There was a statistically significant difference in the cumulative incidence of relapse at 18 months in favor of the FluBu4K regimen, at 12.0% vs 32.5% ( = 0.047). The results of this study indicate that for select patients, there may be benefit in choosing targeted FluBu4K over FluBu2. Adverse effects other than mucositis were not significantly different.
进行了一项回顾性队列研究，以评估每天白消安曲线下面积（AUC）目标为16.4mg×Hr/L（FluBu4K）与传统减低强度预处理方案（FluBu2）在疗效和耐受性方面的差异。纳入了2015年至2018年间接受氟达拉滨+白消安预处理（有或无抗胸腺细胞球蛋白）的成年急性髓系白血病（AML）或骨髓增生异常综合征（MDS）患者。主要结局是无复发生存期。总体而言，74例患者接受了FluBu4K或FluBu2预处理。18个月时，无复发生存率无显著差异，FluBu4K组为63.9%，FluBu2组为57.5%（P=0.49）。18个月时复发的累积发生率有统计学显著差异，FluBu4K方案更具优势，分别为12.0%和32.5%（P=0.047）。这项研究结果表明，对于特定患者，选择靶向FluBu4K而非FluBu2可能有益。除黏膜炎外的不良反应无显著差异。
