- In elderly patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) undergoing cord blood transplantation (CBT), a conditioning regimen using 75% of the standard dose of busulfan/cyclophosphamide (BU/CY) enabled early recovery, high rate of neutrophil engraftment, and acceptable nonrelapse mortality (NRM).
Why this matters
- Conditioning regimens containing standard-dose BU/CY in the elderly have been associated with risk for NRM because of infectious disease.
- Study to evaluate the safety and efficacy of a conditioning regimen using fludarabine (FLU)+75% of the standard dose of BU/CY in 21 older patients with AML (n=9) and MDS (n=12) who received unrelated CBT.
- Median patient age, 65 (range, 58-73) years.
- Funding: None disclosed.
- 19 patients achieved neutrophil engraftment at a median of 19 (range, 14-29) days.
- 90.5% (95% CI, 55.1%-98.3%) cumulative incidence of neutrophil engraftment at day 30.
- 19% (95% CI, 5.7%-38.3%) NRM at day 100; 38.1% (95% CI, 17.6%-58.5%) NRM at 2 years.
- 9.5% (95% CI, 1.5%-26.7%) cumulative relapse at 100 days; 19.0% (95% CI, 5.6%-38.5%) at 2 years.
- Infectious disease was the most common cause of NRM, occurring in 2 patients.
- Retrospective data.