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Several studies in the early 1990s demonstrated that cyclophosphamide (Cy) combined with oral busulfan was inferior to total body irradiation (TBI) for outcomes of myeloablative transplantation. However, since the development of IV busulfan preparations, the optimal preparative regimen has been controversial. Two manuscripts published in this week's issue of Blood compare the outcomes of hematopoietic cell transplant following preparation with cyclophosphamide plus total body irradiation (Cy-TBI) versus IV busulfan (Bu-Cy) and confirm superior results with Bu-Cy, including improved leukemia-free survival and reduced non-relapse mortality, suggesting that this regimen should be the standard of care.
Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI, Edward A. Copelan, Betty K. Hamilton, Belinda Avalos, Kwang Woo Ahn, Brian J. Bolwell, Xiaochun Zhu, Mahmoud Aljurf, Koen van Besien, Christopher Bredeson, Jean-Yves Cahn, Luciano J. Costa, Marcos de Lima, Robert Peter Gale, Gregory A. Hale, Joerg Halter, Mehdi Hamadani, Yoshihiro Inamoto, Rammurti T. Kamble, Mark R. Litzow, Alison W. Loren, David I. Marks, Eduardo Olavarria, Vivek Roy, Mitchell Sabloff, Bipin N. Savani, Matthew Seftel, Harry C. Schouten, Celalettin Ustun, Edmund K. Waller, Daniel J. Weisdorf, Baldeep Wirk, Mary M. Horowitz, Mukta Arora, Jeff Szer, Jorge Cortes, Matt E. Kalaycio, Richard T. Maziarz, and Wael Saber, Blood - doi: 10.1182/blood-2013-07-514448
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11 Mar. 2014. <http://www.medicalnewstoday.com/releases/269851>
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