PMID- 29846964 OWN - NLM STAT- MEDLINE DCOM- 20181211 LR - 20181211 IS - 1600-0609 (Electronic) IS - 0902-4441 (Linking) VI - 101 IP - 3 DP - 2018 Sep TI - Busulfan-based myeloablative conditioning regimens for haploidentical transplantation in high-risk acute leukemias and myelodysplastic syndromes. PG - 332-339 LID - 10.1111/ejh.13103 [doi] AB - BACKGROUND: High-risk acute leukemia (AL) and myelodysplastic syndrome (MDS) remain a therapeutic challenge. Unmanipulated haploidentical-related donor transplantation based on a myeloablative conditioning regimen (HAPLO-MAC) and post-transplant cyclophosphamide (PT-Cy) as prophylaxis against graft vs host disease (GvHD) is now a promising rescue strategy that could become universally available. OBJECTIVE: To evaluate the results of HAPLO-MAC with PT-Cy in patients with AL and MDS reported to the Haploidentical Transplantation Subcommittee of the Spanish Group for Hematopoietic Transplantation (GETH). PATIENTS AND METHODS: We report our multicenter experience using an IV busulfan-based HAPLO-MAC regimen and PT-Cy for treatment of 65 adults with high-risk AL and MDS. RESULTS: Engraftment was recorded in 64 patients (98.5%), with a median time to neutrophil and platelet recovery of 16 and 27 days, respectively. The cumulative incidence of grade II-IV acute GvHD and chronic GvHD was 28.6% and 27.5%, respectively. After a median follow-up of 31 months for survivors, the cumulative incidence of non-relapse mortality and relapse at 2 years was 18.8% and 25%, respectively. Estimated 30-month event-free survival and overall survival were 56% and 54.5%, respectively. CONCLUSION: HAPLO-MAC comprising an IV busulfan-based conditioning regimen enabled long-term disease control with acceptable toxicity in high-risk AL and MDS. CI - (c) 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. FAU - Gayoso, Jorge AU - Gayoso J AUID- ORCID: 0000-0002-6057-6672 AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Balsalobre, Pascual AU - Balsalobre P AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Kwon, Mi AU - Kwon M AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Herrera, Pilar AU - Herrera P AD - Hospital Universitario Ramon y Cajal, Madrid, Spain. FAU - Bermudez, Arancha AU - Bermudez A AD - Hospital Universitario Marques de Valdecilla, Santander, Spain. FAU - Sampol, Antonia AU - Sampol A AD - Hospital Universitario Son Espases, Palma de Mallorca, Spain. FAU - Jimenez, Santiago AU - Jimenez S AD - Hospital Universitario Doctor Negrin, Las Palmas de Gran Canaria, Spain. FAU - Lopez-Corral, Lucia AU - Lopez-Corral L AD - Hospital Clinico Universitario, Salamanca, Spain. FAU - Serrano, David AU - Serrano D AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Pinana, Jose Luis AU - Pinana JL AD - Hospital Universitario La Fe, Valencia, Spain. AD - CIBERONC, Instituto Carlos III, Madrid, Spain. FAU - Pascual, Maria J AU - Pascual MJ AD - Hospital Regional Universitario, Malaga, Spain. FAU - Heras, Inmaculada AU - Heras I AD - HGU Morales Meseguer, Murcia, Spain. FAU - Bento, Leyre AU - Bento L AD - Hospital Universitario Son Espases, Palma de Mallorca, Spain. FAU - Varela, Rosario AU - Varela R AD - Hospital Universitario de A Coruna, A Coruna, Spain. FAU - Humala, Karem AU - Humala K AD - Hospital Universitario La Paz, Madrid, Spain. FAU - Zabalza, Amaya AU - Zabalza A AD - Complejo Hospitalario de Navarra, Pamplona, Spain. FAU - Laiglesia, Almudena AU - Laiglesia A AD - Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. FAU - Bastos-Oreiro, Mariana AU - Bastos-Oreiro M AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Perez-Corral, Ana AU - Perez-Corral A AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Martinez-Laperche, Carolina AU - Martinez-Laperche C AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Buno, Ismael AU - Buno I AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. FAU - Diez-Martin, Jose L AU - Diez-Martin JL AD - Facultad de Medicina Universidad Complutense, HGU Gregorio Maranon, Madrid, Spain. AD - Instituto de Investigacion Sanitaria Gregorio Maranon, Madrid, Spain. CN - GETH (Grupo Espanol de Trasplante Hematopoyetico), Spain LA - eng PT - Journal Article PT - Multicenter Study DEP - 20180803 PL - England TA - Eur J Haematol JT - European journal of haematology JID - 8703985 RN - G1LN9045DK (Busulfan) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Busulfan/*administration & dosage MH - Combined Modality Therapy MH - Female MH - Graft vs Host Disease/etiology/prevention & control MH - *Hematopoietic Stem Cell Transplantation/adverse effects/methods MH - Humans MH - Leukemia/diagnosis/mortality/*therapy MH - Male MH - Middle Aged MH - Myelodysplastic Syndromes/diagnosis/mortality/*therapy MH - Recurrence MH - Retreatment MH - Survival Analysis MH - *Transplantation Conditioning MH - *Transplantation, Haploidentical MH - Treatment Outcome MH - Young Adult OTO - NOTNLM OT - acute leukemia OT - haploidentical transplantation OT - myeloablative conditioning OT - myelodysplastic syndromes OT - post-transplant cyclophosphamide EDAT- 2018/05/31 06:00 MHDA- 2018/12/12 06:00 CRDT- 2018/05/31 06:00 PHST- 2018/05/24 00:00 [accepted] PHST- 2018/05/31 06:00 [pubmed] PHST- 2018/12/12 06:00 [medline] PHST- 2018/05/31 06:00 [entrez] AID - 10.1111/ejh.13103 [doi] PST - ppublish SO - Eur J Haematol. 2018 Sep;101(3):332-339. doi: 10.1111/ejh.13103. Epub 2018 Aug 3.