J Korean Cancer Assoc.  1997 Oct;29(5):874-885.

A Preliminary Report of Busulfan, Melphalan and Thiotepa or TBI-containing Bi-alkylator Chemotherapy as a Preparative Regimen for Allogeneic Bone Marrow Transplantation in Refractory or Relapsed Acute Leukemias

• Kim HJ
• Min WS
• Park SK
• Kim DW
• Lee JW
• Han CH
• Kim CC
• Kim DJ

Abstract

PURPOSE: We assessed the three-alkylator combination of busulfan, melphalan and thiotepa or TBI, melphalan and thiotepa conditioning for allogeneic stem cell transplantation in 7 adult patients with refractory or relapsed acute leukemias.
MATERIALS AND METHODS
Six patients were transplanted for acute myeloid leukemia, one for acute lymphoblastic leukemia and included 5 of relapsed refractory, 2 of relapsed after first-BMT. All but 1 cases received G-CSF stimulated CD34+ allogeneic peripheral blood progenitor cells (PBPCs) in addition to stimulated allogeneic marrow.
RESULTS
All patients except one engrafted (median time to ANC >0.5 10 (9)/L=11days, to platelets >30 X 10 (9)/L=14 days) successfully and complete remission was obtained in 6 patients. Grade I-II acute GVHD and controllable regimen-related toxicity especially oral mucositis (grade II-III) developed in all cases, but 2 patients including one second- allogeneic BMT patient expired early by transplant-related toxicity of hepatic or multiorgan failure along the course of sepsis.
CONCLUSION
Although the observation period on these cases are limited, the data presented show that the combination of busulfan, melphalan and thiotepa is tolerable as a preparative regimen for allogeneic marrow transplantation in high-risk leukemic patients. We think that these encouraging results need to be confirmed in prospective studies in the future.

Keyword

Refractory and Relapsed leukemia; Busulfan; Melphalan; Thiotepa; Allogeneic BMT; PBPCs

MeSH Terms

Adult
Bone Marrow Transplantation*
Bone Marrow*
Busulfan*
Drug Therapy*
Granulocyte Colony-Stimulating Factor
Humans
Leukemia*
Leukemia, Myeloid, Acute
Melphalan*
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Sepsis
Stem Cell Transplantation
Stem Cells
Stomatitis
Thiotepa*
Busulfan
Granulocyte Colony-Stimulating Factor
Melphalan
Thiotepa