Idarubicin-intensified BUCY2 conditioning regimen improved survival in high-risk acute myeloid, but not lymphocytic leukemia patients undergoing allogeneic hematopoietic stem cell transplantation: A retrospective comparative study

Idarubicin-Intensified Hematopoietic Cell Transplantation Improves Relapse and Survival of High-Risk Acute Leukemia Patients with Minimal Residual Disease

“…A cohort of 98 consecutive patients with high-risk acute leukemia who underwent their first allo-HSCT using IDA-intensified conditioning regimens from January 2012 to January 2017 at the Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were included in this retrospective study. We classified patients as high risk at diagnosis following the criteria in our previous reports [9][10][11][12]. The definition of high-risk AML were no response to induction chemotherapy, relapse within 6 months after induction or consolidation therapy, relapse within 6 months after induction therapy that could not be relieved using the original induction therapy, 2 relapses or relapse after auto-HSCT, unfavorable cytogenetics, or a history of preceding neoplasia and/or chemotherapy in no remission (NR).…”

“…The definition of hematopoietic engraftment was similar to that reported previously [9][10][11][12]. Chimerism was typically evaluated in recipient BM or whole peripheral blood without separation usually on days +30, +90, +180, +270, and +360 after transplantation.…”

“…Institutional standard antimicrobial prophylaxis covering fungal and bacterial agents were administered in all patients [9][10][11][12]. Cytomegalovirus (CMV) monitoring was performed once a week using a RT Taqman CMV DNA PCR until day 100 after allo-HSCT, then once every 2 weeks until day 180, followed by once every month until 1 year after HSCT.…”

“…In HLA-matched related or unrelated allo-HSCT for acute leukemia, several studies have reported a dose-dependent effect of the intensity of the conditioning regimen on disease control. In our previous studies, we demonstrated that allo-HSCT using idarubicin (IDA)-intensified conditioning regimens could reduce relapse of high-risk acute leukemia patients, which translated into improved survival [9][10][11][12]. One might anticipate that the intensity of the preparative regimen would be of greater importance in patients with MRD because more effective leukemic cell clearance and deeper molecular response are potentially achievable with intensified conditioning regimen for these high-risk patients.…”

Investigation of oral and general health status and IL-1β gene polymorphism as risk factors for oral mucositis in hematopoietic stem cell transplantation patients

“…A high incidence of severe oral toxicity is observed i n pat ient s w it h mu lt iple myelom a (MM), non-Hodgkin's lymphoma (NHL), and acute myeloid leukemia (AML) who have received highdose melphalan, BEAM (carmustine, etoposide, cytarabine, and melphalan), and BuCy (busulfan plus cyclophosphamide) conditioning regimens, respectively, and autologous or allogeneic HSCT. 11,12 A preventive protocol using photobiomodulation (PBM) is currently considered to be an important tool for the reduction of the incidence and severity of OM in patients receiving high doses of chemotherapy and/ or radiotherapy before HSCT. 13,14 Also, some studies have demonstrated an economic value of PBM based on the fact that this tool reduces costs that result in savings of US$5,000 per prevented OM case.…”