Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation

Edward A. Copelan; Belinda R. Avalos; Kwang Woo Ahn; Xiaochun Zhu; Robert Peter Gale; Michael R. Grunwald; Mehdi Hamadani; Betty K. Hamilton; Gregory A. Hale; David I. Marks; Edmund K. Waller; Bipin N. Savani; Luciano J. Costa; Muthalagu Ramanathan; Jean-Yves Cahn; H. Jean Khoury; Daniel J. Weisdorf; Yoshihiro Inamoto; Rammurti T. Kamble; Harry C. Schouten; Baldeep Wirk; Mark R. Litzow; Mahmoud D. Aljurf; Koen W. van Besien; Celalettin Ustun; Brian J. Bolwell; Christopher N. Bredeson; Omotayo Fasan; Nilanjan Ghosh; Mary M. Horowitz; Mukta Arora; Jeffrey Szer; Alison W. Loren; Edwin P. Alyea; Jorge Cortes; Richard T. Maziarz; Matt E. Kalaycio; Wael Saber

doi:10.1016/j.bbmt.2014.12.010

Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation

Edward A. Copelan^*, Belinda R. Avalos, Kwang Woo Ahn, Xiaochun Zhu, Robert Peter Gale, Michael R. Grunwald, Mehdi Hamadani, Betty K. Hamilton, Gregory A. Hale, David I. Marks, Edmund K. Waller, Bipin N. Savani, Luciano J. Costa, Muthalagu Ramanathan, Jean-Yves Cahn, H. Jean Khoury, Daniel J. Weisdorf, Yoshihiro Inamoto, Rammurti T. Kamble, Harry C. SchoutenBaldeep Wirk, Mark R. Litzow, Mahmoud D. Aljurf, Koen W. van Besien, Celalettin Ustun, Brian J. Bolwell, Christopher N. Bredeson, Omotayo Fasan, Nilanjan Ghosh, Mary M. Horowitz, Mukta Arora, Jeffrey Szer, Alison W. Loren, Edwin P. Alyea, Jorge Cortes, Richard T. Maziarz, Matt E. Kalaycio, Wael Saber

^*Corresponding author for this work

GROW - Innovative Cancer Diagnostics & Therapy

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Cyclophosphamide (Cy) in combination with busulfan (Bu) or total body irradiation (TBI) is the most commonly used myeloablative conditioning regimen in patients with chronic myeloid leukemia (CML). We used data from the Center for International Bone Marrow Transplantation Research to compare outcomes in adults who underwent hematopoietic cell transplantation for CML in first chronic phase after myeloablative conditioning with Cy in combination with TBI, oral Bu, or intravenous (i.v.) Bu. Four hundred thirty-eight adults received human leukocyte antigen (HLA)-matched sibling grafts and 235 received well-matched grafts from unrelated donors (URD) from 2000 through 2006. Important differences existed between the groups in distribution of donor relation, exposure to tyrosine kinase inhibitors, and year of transplantation. In multivariate analysis, relapse occurred less frequently among patients receiving i.v. Bu compared with TBI (relative risk [RR], .36; P = .022) or oral Bu (RR, .39; P = .028), but nonrelapse mortality and survival were similar. A significant interaction was detected between donor relation and the main effect in leukemia-free survival (LFS). Among recipients of HLA-identical sibling grafts, but not URD grafts, LFS was better in patients receiving i.v. Bu (RR, .53; P = .025) or oral Bu (RR, .64; P = .017) compared with TBI. In CML in first chronic phase, Cy in combination with i.v. Bu was associated with less relapse than TBI or oral Bu. LFS was better after i.v. or oral Bu compared with TBI. American Society for Blood and Marrow Transplantation.

Original language	English
Pages (from-to)	552-558
Journal	Biology of Blood and Marrow Transplantation
Volume	21
Issue number	3
DOIs	https://doi.org/10.1016/j.bbmt.2014.12.010
Publication status	Published - Mar 2015

Keywords

Chronic myeloid leukemia
Busulfan
Total body irradiation

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10.1016/j.bbmt.2014.12.010Licence: CC BY-NC-ND

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Copelan, E. A., Avalos, B. R., Ahn, K. W., Zhu, X., Gale, R. P., Grunwald, M. R., Hamadani, M., Hamilton, B. K., Hale, G. A., Marks, D. I., Waller, E. K., Savani, B. N., Costa, L. J., Ramanathan, M., Cahn, J.-Y., Khoury, H. J., Weisdorf, D. J., Inamoto, Y., Kamble, R. T., ... Saber, W. (2015). Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation. Biology of Blood and Marrow Transplantation, 21(3), 552-558. https://doi.org/10.1016/j.bbmt.2014.12.010

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title = "Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation",

abstract = "Cyclophosphamide (Cy) in combination with busulfan (Bu) or total body irradiation (TBI) is the most commonly used myeloablative conditioning regimen in patients with chronic myeloid leukemia (CML). We used data from the Center for International Bone Marrow Transplantation Research to compare outcomes in adults who underwent hematopoietic cell transplantation for CML in first chronic phase after myeloablative conditioning with Cy in combination with TBI, oral Bu, or intravenous (i.v.) Bu. Four hundred thirty-eight adults received human leukocyte antigen (HLA)-matched sibling grafts and 235 received well-matched grafts from unrelated donors (URD) from 2000 through 2006. Important differences existed between the groups in distribution of donor relation, exposure to tyrosine kinase inhibitors, and year of transplantation. In multivariate analysis, relapse occurred less frequently among patients receiving i.v. Bu compared with TBI (relative risk [RR], .36; P = .022) or oral Bu (RR, .39; P = .028), but nonrelapse mortality and survival were similar. A significant interaction was detected between donor relation and the main effect in leukemia-free survival (LFS). Among recipients of HLA-identical sibling grafts, but not URD grafts, LFS was better in patients receiving i.v. Bu (RR, .53; P = .025) or oral Bu (RR, .64; P = .017) compared with TBI. In CML in first chronic phase, Cy in combination with i.v. Bu was associated with less relapse than TBI or oral Bu. LFS was better after i.v. or oral Bu compared with TBI. American Society for Blood and Marrow Transplantation.",

keywords = "Chronic myeloid leukemia, Busulfan, Total body irradiation",

author = "Copelan, {Edward A.} and Avalos, {Belinda R.} and Ahn, {Kwang Woo} and Xiaochun Zhu and Gale, {Robert Peter} and Grunwald, {Michael R.} and Mehdi Hamadani and Hamilton, {Betty K.} and Hale, {Gregory A.} and Marks, {David I.} and Waller, {Edmund K.} and Savani, {Bipin N.} and Costa, {Luciano J.} and Muthalagu Ramanathan and Jean-Yves Cahn and Khoury, {H. Jean} and Weisdorf, {Daniel J.} and Yoshihiro Inamoto and Kamble, {Rammurti T.} and Schouten, {Harry C.} and Baldeep Wirk and Litzow, {Mark R.} and Aljurf, {Mahmoud D.} and {van Besien}, {Koen W.} and Celalettin Ustun and Bolwell, {Brian J.} and Bredeson, {Christopher N.} and Omotayo Fasan and Nilanjan Ghosh and Horowitz, {Mary M.} and Mukta Arora and Jeffrey Szer and Loren, {Alison W.} and Alyea, {Edwin P.} and Jorge Cortes and Maziarz, {Richard T.} and Kalaycio, {Matt E.} and Wael Saber",

year = "2015",

month = mar,

doi = "10.1016/j.bbmt.2014.12.010",

language = "English",

volume = "21",

pages = "552--558",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

publisher = "Elsevier Science",

number = "3",

}

Copelan, EA, Avalos, BR, Ahn, KW, Zhu, X, Gale, RP, Grunwald, MR, Hamadani, M, Hamilton, BK, Hale, GA, Marks, DI, Waller, EK, Savani, BN, Costa, LJ, Ramanathan, M, Cahn, J-Y, Khoury, HJ, Weisdorf, DJ, Inamoto, Y, Kamble, RT, Schouten, HC, Wirk, B, Litzow, MR, Aljurf, MD, van Besien, KW, Ustun, C, Bolwell, BJ, Bredeson, CN, Fasan, O, Ghosh, N, Horowitz, MM, Arora, M, Szer, J, Loren, AW, Alyea, EP, Cortes, J, Maziarz, RT, Kalaycio, ME & Saber, W 2015, 'Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation', Biology of Blood and Marrow Transplantation, vol. 21, no. 3, pp. 552-558. https://doi.org/10.1016/j.bbmt.2014.12.010

Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation. / Copelan, Edward A.; Avalos, Belinda R.; Ahn, Kwang Woo et al.
In: Biology of Blood and Marrow Transplantation, Vol. 21, No. 3, 03.2015, p. 552-558.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Comparison of Outcomes of Allogeneic Transplantation for Chronic Myeloid Leukemia with Cyclophosphamide in Combination with Intravenous Busulfan, Oral Busulfan, or Total Body Irradiation

AU - Copelan, Edward A.

AU - Avalos, Belinda R.

AU - Ahn, Kwang Woo

AU - Zhu, Xiaochun

AU - Gale, Robert Peter

AU - Grunwald, Michael R.

AU - Hamadani, Mehdi

AU - Hamilton, Betty K.

AU - Hale, Gregory A.

AU - Marks, David I.

AU - Waller, Edmund K.

AU - Savani, Bipin N.

AU - Costa, Luciano J.

AU - Ramanathan, Muthalagu

AU - Cahn, Jean-Yves

AU - Khoury, H. Jean

AU - Weisdorf, Daniel J.

AU - Inamoto, Yoshihiro

AU - Kamble, Rammurti T.

AU - Schouten, Harry C.

AU - Wirk, Baldeep

AU - Litzow, Mark R.

AU - Aljurf, Mahmoud D.

AU - van Besien, Koen W.

AU - Ustun, Celalettin

AU - Bolwell, Brian J.

AU - Bredeson, Christopher N.

AU - Fasan, Omotayo

AU - Ghosh, Nilanjan

AU - Horowitz, Mary M.

AU - Arora, Mukta

AU - Szer, Jeffrey

AU - Loren, Alison W.

AU - Alyea, Edwin P.

AU - Cortes, Jorge

AU - Maziarz, Richard T.

AU - Kalaycio, Matt E.

AU - Saber, Wael

PY - 2015/3

Y1 - 2015/3

N2 - Cyclophosphamide (Cy) in combination with busulfan (Bu) or total body irradiation (TBI) is the most commonly used myeloablative conditioning regimen in patients with chronic myeloid leukemia (CML). We used data from the Center for International Bone Marrow Transplantation Research to compare outcomes in adults who underwent hematopoietic cell transplantation for CML in first chronic phase after myeloablative conditioning with Cy in combination with TBI, oral Bu, or intravenous (i.v.) Bu. Four hundred thirty-eight adults received human leukocyte antigen (HLA)-matched sibling grafts and 235 received well-matched grafts from unrelated donors (URD) from 2000 through 2006. Important differences existed between the groups in distribution of donor relation, exposure to tyrosine kinase inhibitors, and year of transplantation. In multivariate analysis, relapse occurred less frequently among patients receiving i.v. Bu compared with TBI (relative risk [RR], .36; P = .022) or oral Bu (RR, .39; P = .028), but nonrelapse mortality and survival were similar. A significant interaction was detected between donor relation and the main effect in leukemia-free survival (LFS). Among recipients of HLA-identical sibling grafts, but not URD grafts, LFS was better in patients receiving i.v. Bu (RR, .53; P = .025) or oral Bu (RR, .64; P = .017) compared with TBI. In CML in first chronic phase, Cy in combination with i.v. Bu was associated with less relapse than TBI or oral Bu. LFS was better after i.v. or oral Bu compared with TBI. American Society for Blood and Marrow Transplantation.

AB - Cyclophosphamide (Cy) in combination with busulfan (Bu) or total body irradiation (TBI) is the most commonly used myeloablative conditioning regimen in patients with chronic myeloid leukemia (CML). We used data from the Center for International Bone Marrow Transplantation Research to compare outcomes in adults who underwent hematopoietic cell transplantation for CML in first chronic phase after myeloablative conditioning with Cy in combination with TBI, oral Bu, or intravenous (i.v.) Bu. Four hundred thirty-eight adults received human leukocyte antigen (HLA)-matched sibling grafts and 235 received well-matched grafts from unrelated donors (URD) from 2000 through 2006. Important differences existed between the groups in distribution of donor relation, exposure to tyrosine kinase inhibitors, and year of transplantation. In multivariate analysis, relapse occurred less frequently among patients receiving i.v. Bu compared with TBI (relative risk [RR], .36; P = .022) or oral Bu (RR, .39; P = .028), but nonrelapse mortality and survival were similar. A significant interaction was detected between donor relation and the main effect in leukemia-free survival (LFS). Among recipients of HLA-identical sibling grafts, but not URD grafts, LFS was better in patients receiving i.v. Bu (RR, .53; P = .025) or oral Bu (RR, .64; P = .017) compared with TBI. In CML in first chronic phase, Cy in combination with i.v. Bu was associated with less relapse than TBI or oral Bu. LFS was better after i.v. or oral Bu compared with TBI. American Society for Blood and Marrow Transplantation.

KW - Chronic myeloid leukemia

KW - Busulfan

KW - Total body irradiation

U2 - 10.1016/j.bbmt.2014.12.010

DO - 10.1016/j.bbmt.2014.12.010

M3 - Article

C2 - 25528388

SN - 1083-8791

VL - 21

SP - 552

EP - 558

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

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ER -