[The toxicity of busulphan and cyclophosphamide as the preparative regimen for allogeneic peripheral blood stem cell transplantation].

OBJECTIVE

To analyse the treatment-related complications of busulphan and cyclophosphamide (BU-CY) as the conditioning regimen for allogeneic peripheral blood stem cell transplantation (allo-PBSCT).

METHODS

The clinical data of 40 leukemia patients undergoing allo-PBSCT between June 1997 and May 1999 in our BMT center were retrospectively analysed.

RESULTS

Recovery of neutrophil and platelet was achieved at a median of day +13 (9 - 28) and day +12 (7 - 60) respectively. Acute GVHD occurred in 17 of 40 patients (42.5%) with grade II-IV in 10 patients (25%). Chronic GVHD developed in 21 out of 30 evaluable patients (70%). Mild to severe mucositis occurred in 30 patients (75%), and 4 of them had severe esophagitis with bleeding. Haemorrhagic cystitis developed in 8/40 (20%) patients, the median time of its onset was day +100 (+7 to +165). Six of 40 patients (15%) developed interstitial pneumonia (IP), 5 of them were due to cytomegalovirus infection, and the remaining one due to pneumocystis carinii infection. No hepatic veno-occlusive disease was observed and no seizure occurred. During the median follow-up of 480 (300 - 1000) days, 4 (10%) patients relapsed and 8 (20%) patients died of the transplant-related complications. The 3 year leukemia-free survival rate was 70%.

CONCLUSION

BU (domestic busulfan)-CY regimen is relatively easy to administer and well tolerated, with low extramedullary toxicities.