Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia

Motohiro Kato, Yoshiyuki Takahashi, Daisuke Tomizawa, Yasuhiro Okamoto, Jiro Inagaki, Katsuyoshi Koh, Atsushi Ogawa, Keiko Okada, Yuko Cho, Junko Takita, Hiroaki Goto, Hisashi Sakamaki, Hiromasa Yabe, Keisei Kawa, Ritsuro Suzuki, Kazuko Kudo, Koji Kato

Research output: Contribution to journalArticle

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Abstract

Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n=198) or oral busulfan (oral-BU) (n=262) myeloablative conditioning. OS at 3years was 53.4%±3.7% with iv-BU and 55.1%±3.1% with oral-BU; the difference was not statistically significant (P= 77). OS at 3years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4%±5.5% with iv-BU and 54.6%±4.1 with oral-BU (P= 51) and 51.0%±5.0% with iv-BU and 55.8%±4.8% with oral-BU (P= 83), respectively. Cumulative incidence of relapse at 3years with iv-BU was similar to that with oral-BU (39.0%±3.6% and 36.4%±3.1%, respectively; P= 67). Cumulative incidence of NRM at 3years was 16.6%±2.7% with iv-BU and 18.3%±2.5% with oral-BU (P= 51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia.

Original languageEnglish
Pages (from-to)1690-1694
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume19
Issue number12
DOIs
Publication statusPublished - Dec 1 2013
Externally publishedYes

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Busulfan
Hematopoietic Stem Cell Transplantation
Leukemia
Pediatrics
Survival
Mortality
Incidence
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia. / Kato, Motohiro; Takahashi, Yoshiyuki; Tomizawa, Daisuke; Okamoto, Yasuhiro; Inagaki, Jiro; Koh, Katsuyoshi; Ogawa, Atsushi; Okada, Keiko; Cho, Yuko; Takita, Junko; Goto, Hiroaki; Sakamaki, Hisashi; Yabe, Hiromasa; Kawa, Keisei; Suzuki, Ritsuro; Kudo, Kazuko; Kato, Koji.

In: Biology of Blood and Marrow Transplantation, Vol. 19, No. 12, 01.12.2013, p. 1690-1694.

Research output: Contribution to journalArticle

Kato, M, Takahashi, Y, Tomizawa, D, Okamoto, Y, Inagaki, J, Koh, K, Ogawa, A, Okada, K, Cho, Y, Takita, J, Goto, H, Sakamaki, H, Yabe, H, Kawa, K, Suzuki, R, Kudo, K & Kato, K 2013, 'Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia', Biology of Blood and Marrow Transplantation, vol. 19, no. 12, pp. 1690-1694. https://doi.org/10.1016/j.bbmt.2013.09.012
Kato, Motohiro ; Takahashi, Yoshiyuki ; Tomizawa, Daisuke ; Okamoto, Yasuhiro ; Inagaki, Jiro ; Koh, Katsuyoshi ; Ogawa, Atsushi ; Okada, Keiko ; Cho, Yuko ; Takita, Junko ; Goto, Hiroaki ; Sakamaki, Hisashi ; Yabe, Hiromasa ; Kawa, Keisei ; Suzuki, Ritsuro ; Kudo, Kazuko ; Kato, Koji. / Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia. In: Biology of Blood and Marrow Transplantation. 2013 ; Vol. 19, No. 12. pp. 1690-1694.
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abstract = "Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n=198) or oral busulfan (oral-BU) (n=262) myeloablative conditioning. OS at 3years was 53.4{\%}±3.7{\%} with iv-BU and 55.1{\%}±3.1{\%} with oral-BU; the difference was not statistically significant (P= 77). OS at 3years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4{\%}±5.5{\%} with iv-BU and 54.6{\%}±4.1 with oral-BU (P= 51) and 51.0{\%}±5.0{\%} with iv-BU and 55.8{\%}±4.8{\%} with oral-BU (P= 83), respectively. Cumulative incidence of relapse at 3years with iv-BU was similar to that with oral-BU (39.0{\%}±3.6{\%} and 36.4{\%}±3.1{\%}, respectively; P= 67). Cumulative incidence of NRM at 3years was 16.6{\%}±2.7{\%} with iv-BU and 18.3{\%}±2.5{\%} with oral-BU (P= 51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia.",
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T1 - Comparison of Intravenous with Oral Busulfan in Allogeneic Hematopoietic Stem Cell Transplantation with Myeloablative Conditioning Regimens for Pediatric Acute Leukemia

AU - Kato, Motohiro

AU - Takahashi, Yoshiyuki

AU - Tomizawa, Daisuke

AU - Okamoto, Yasuhiro

AU - Inagaki, Jiro

AU - Koh, Katsuyoshi

AU - Ogawa, Atsushi

AU - Okada, Keiko

AU - Cho, Yuko

AU - Takita, Junko

AU - Goto, Hiroaki

AU - Sakamaki, Hisashi

AU - Yabe, Hiromasa

AU - Kawa, Keisei

AU - Suzuki, Ritsuro

AU - Kudo, Kazuko

AU - Kato, Koji

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n=198) or oral busulfan (oral-BU) (n=262) myeloablative conditioning. OS at 3years was 53.4%±3.7% with iv-BU and 55.1%±3.1% with oral-BU; the difference was not statistically significant (P= 77). OS at 3years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4%±5.5% with iv-BU and 54.6%±4.1 with oral-BU (P= 51) and 51.0%±5.0% with iv-BU and 55.8%±4.8% with oral-BU (P= 83), respectively. Cumulative incidence of relapse at 3years with iv-BU was similar to that with oral-BU (39.0%±3.6% and 36.4%±3.1%, respectively; P= 67). Cumulative incidence of NRM at 3years was 16.6%±2.7% with iv-BU and 18.3%±2.5% with oral-BU (P= 51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia.

AB - Recent reports revealed that intravenous (iv) busulfan (BU) may not only reduce early nonrelapse mortality (NRM) but also improve overall survival (OS) probability in adults. Therefore, we retrospectively compared outcomes for 460 children with acute leukemia who underwent hematopoietic stem cell transplantation with either iv-BU (n=198) or oral busulfan (oral-BU) (n=262) myeloablative conditioning. OS at 3years was 53.4%±3.7% with iv-BU and 55.1%±3.1% with oral-BU; the difference was not statistically significant (P= 77). OS at 3years in 241 acute lymphoblastic leukemia and 219 acute myeloid leukemia patients was 56.4%±5.5% with iv-BU and 54.6%±4.1 with oral-BU (P= 51) and 51.0%±5.0% with iv-BU and 55.8%±4.8% with oral-BU (P= 83), respectively. Cumulative incidence of relapse at 3years with iv-BU was similar to that with oral-BU (39.0%±3.6% and 36.4%±3.1%, respectively; P= 67). Cumulative incidence of NRM at 3years was 16.6%±2.7% with iv-BU and 18.3%±2.5% with oral-BU (P= 51). Furthermore, multivariate analysis showed no significant survival advantage with iv-BU. In conclusion, iv-BU failed to show a significant survival advantage in children with acute leukemia.

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