Department of Hematopoietic Stem Cell Transplantation, Taleghani Hospital, Shahid Beheshti University of Medical Seience, Tehran, Iran.
Department of Hematology and Oncology, Taleghani Hospital, Shahid Beheshti University of Medical Seience, Tehran, Iran.
Asian Pac J Cancer Prev. 2021 May 1;22(5):1639-1644. doi: 10.31557/APJCP.2021.22.5.1639.
The side effects of conditioning regimens on the success rate of allogeneic transplantation around the world have been challenging. In this study, we aimed to investigate the side effect of Bu/Cy and Bu/Flu regimens on our patients who underwent allogeneic bone marrow transplantation.
We analyzed 180 patients receiving bone marrow transplantation in Taleghani Hospital, in Tehran, Iran between April 2016 and December 2019. Patients in group A received a combination of intravenous busulfan 0.8 mg/kg QID over two hours for 4 consecutive days (12.8 mg/kg in total)(Savani et al., 2006) and cyclophosphamide 60 mg/kg per day for two consecutive days. Patients in group B received busulfan the same as the first group in combination with fludarabine equal to 40 mg/m² per day. Patients were followed up at regular intervals up to two years after transplantation.
Various items were evaluated for patients, including cardiopulmonary function, psychological disorders, GVHD, and endocrine disorders such as hypothyroidism, fertility, or gonad dysfunction. Primary hypothyroidism developed in 13.3% and 11.1% of the Bu/Cy and Bu/Flu groups, respectively (p=0.230). None of the patients in either group experienced infertility or gonad dysfunction. In group A versus group B, pulmonary diseases were detected in 4.4% versus 6.6% of BMT recipients, respectively (p = 0.223). In both groups, mitral and tricuspid regurgitation were observed in patients (8.9% vs. 11.1%; p = 0.189). Incidence of Psychological disorders was no significant difference between the two groups. 32.2% of group A versus 34.45% of group B had skin and liver GVHD, respectively (p = 0.235).
The therapeutic-related adverse effects of the two conditioning regimens in patients who underwent allogeneic bone marrow transplant were almost similar. To improve quality of life and overall survival among BMT patients, careful evaluation of treatment-related complications should be part of the regular follow-up of them.
世界各地同种异体移植中预处理方案的副作用一直是一个挑战。本研究旨在探讨我们接受同种异体骨髓移植患者的 Bu/Cy 和 Bu/Flu 方案的副作用。
我们分析了 2016 年 4 月至 2019 年 12 月在伊朗德黑兰 Taleghani 医院接受骨髓移植的 180 名患者。A 组患者接受静脉注射白消安 0.8mg/kg QID 持续两小时，共 4 天（共 12.8mg/kg）（Savani 等人，2006 年）和环磷酰胺 60mg/kg 连续两天。B 组患者接受与第一组相同的白消安，联合氟达拉滨 40mg/m²/天。患者在移植后定期随访长达两年。
对患者进行了心肺功能、心理障碍、GVHD 和甲状腺功能减退等内分泌紊乱、生育或性腺功能障碍等各项评估。Bu/Cy 和 Bu/Flu 组分别有 13.3%和 11.1%的患者发生原发性甲状腺功能减退（p=0.230）。两组均无患者出现不孕或性腺功能障碍。在 A 组与 B 组中，分别有 4.4%和 6.6%的 BMT 受者发生肺部疾病（p=0.223）。两组患者均观察到二尖瓣和三尖瓣反流（8.9%vs.11.1%；p=0.189）。两组间心理障碍发生率无显著差异。A 组 32.2%和 B 组 34.45%的患者分别发生皮肤和肝脏 GVHD（p=0.235）。
接受同种异体骨髓移植的患者两种预处理方案的治疗相关不良影响几乎相似。为提高 BMT 患者的生活质量和总体生存率，应将治疗相关并发症的评估纳入他们的定期随访中。
