Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI

Academic Article


  • Cyclophosphamide combined with total body irradiation (Cy/TBI) or busulfan (BuCy) are the most widely used myeloablative conditioning regimens for allotransplants. Recent data regarding their comparative effectiveness are lacking. We analyzed data from the Center for International Blood and Marrow Transplant Research for 1230 subjects receiving a first hematopoietic cell transplant from a human leukocyte antigen-matched sibling or from an unrelated donor during the years 2000 to 2006 for acute myeloid leukemia (AML) in first complete remission (CR) after conditioning with Cy/TBI or oral or intravenous (4) BuCy. Multivariate analysis showed significantly less nonrelapse mortality (relative risk [RR]= 0.58; 95% confidence interval [CI]: 0.39-0.86; P = .007), and relapse after, but not before, 1 year posttransplant (RR=0.23; 95% CI: 0.08-0.65; P=.006), and better leukemia-free survival (RR=0.70; 95% CI: 0.55-0.88; P = .003) and survival (RR = 0.68; 95% CI: 0.52-0.88; P = .003) in persons receiving 4, but not oral, Bu compared with TBI. In combination with Cy, 4 Bu is associated with superior outcomes compared with TBI in patients with AML in first CR. © 2013 by The American Society of Hematology.
  • Published In

  • Blood  Journal
  • Digital Object Identifier (doi)

    Author List

  • Copelan EA; Hamilton BK; Avalos B; Ahn KW; Bolwell BJ; Zhu X; Aljurf M; Van Besien K; Bredeson C; Cahn JY
  • Start Page

  • 3863
  • End Page

  • 3870
  • Volume

  • 122
  • Issue

  • 24