The clinical research of allogeneic hematopoietic stem cell transplantation using intravenous Bu/Flu conditioning regimen in the treatment of myeloid hematopathy

Objective To evaluate the efficacy of intravenous Bu/Flu conditioning regimen for the treatment of myeloid hematopathy in patients receiving allogeneic hematopoietic stem cell transplantation.Methods Nine patients with acute nonlymphocytic leukemia(ANLL,n=3),chronic myelogenous leukemia(CML,n=5),and myelodysplastic syndrome(MDS,n=1)were treated by allogeneic hematopoietic stem cell transplantation using intravenous Bu/Flu conditioning regimen,which consisted of busulfex[3.2 mg/(kg·d)for 4 days],and fludarabine[30 mg/(m2·d)for 5 days].All patients received cyclosporin A(CsA)and mycophenolet mofetil(MMF)for prophylaxis of graft-versus-host disease(GVHD).Results The intravenous Bu/Flu regimen was very well tolerated,with no severe regimen related toxicity.In all the 9 patients absolute neutrophil count 0.5×109/L was achieved in 10 to 16(median 12)days and platelet count 20×109/L in 12 to 19(median 14)days after transplantation.Complete chimerism was achieved in all the patients at one month after HSCT.Two patients had acute GVHD and one had chronic GVHD.With a median follow-up of 31(19~37)months,8 of 9 patients were alive and disease-free.Conclusion The intravenous Bu/Flu conditioning regimen may reduce transplantation-related toxicities and can achieve full chimerism and high long-term disease-free survival.Allogeneic hematopoietic stem cell transplantation using intravenous Bu/Flu conditioning regimen is a safe and effective option for the patients with myeloid hematopathy.