Clinical efficacy of conditioning regimen using clarithromycin in combination with busulfan and cytarabine in patients with acute myeloid leukemia before allogeneic hematopoietic stem cell transplantation
Objective To explore the clinical efficacy and safety of a three drug conditioning regimen consisting of busufan,cladribin and cytarabine in allogeneic hematopoietic stem cell transplantation(allo-HSCT)for treating acute myeloid leukemia(AML).Methods A retrospective analysis was conducted on clinical data of 79 AML patients undergoing allo HSCT from August 2016 to February 2024 in the Second Affiliated Hospital of Air Force Military Medical University.All patients received the conditioning regimen using cladribin in combination with busulfan and cytarabine before transplantation.The implantation status,incidence of acute/chronic graft-versus-host disease(a/cGVHD),infection incidence,recurrence rate,conditioning-related toxic reactions,overall survival(OS),progression free survival(PFS)and risk factors affecting prognosis were analyzed.Results The time of granulograft implantation in the 79 AML patients was 13(7,20)days,and the median time of platelet implantation was 14(8,22)days.Acute GVHD occurred in 10 patients,chronic GVHD occurred in 15 patients,and GVHD occurred in 22 of 64 patients with haploid donors,with an incidence of 34.38%.GVHD occurred in 3 of 15 patients with total donors,with an incidence of 20.00%.Within 100 days after transplantation,3 patients died due to infection and 1 patient died due to cerebral hemorrhage.The 1-year cumulative recurrence rate and transplant-related mortality were 16.45%and 5.06%,respectively.The 1-year expected OS and PFS were 80.7%and 77.5%,respectively.Multivariate regression showed that maintenance therapy after transplantation and negative minimal residual disease(M-RD)before transplantation were risk factors for survival(both P＜0.05).Conclusion For AML patients with allo-HSCT indications,a three-drug conditioning regimen using cladobine in combination with alsulafil and cytarabine can be adopted to reduce pretreat-ment-related toxicity and it is of good safety.This regimen plus post-transplantation maintenance therapy can result in low transplan-tation recurrence rate.
万方数据
维普
