Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT)
Background: Busulfan (BU) in combination with cyclophosphamide (CY) is used as an effective conditioning regimen in hematopoietic SCT. Busulfan, depletes glutathione level in liver and causes elevated levels of CY metabolites. Cyclophosphamide metabolites are highly toxic for sinusoidal endothelial...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Tehran University of Medical Sciences
2020-07-01
|
Series: | International Journal of Hematology-Oncology and Stem Cell Research |
Subjects: | |
Online Access: | https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1152 |
id |
doaj-c7d379469e2e45cd870998d32d9e8625 |
---|---|
record_format |
Article |
spelling |
doaj-c7d379469e2e45cd870998d32d9e86252020-11-25T04:08:31ZengTehran University of Medical SciencesInternational Journal of Hematology-Oncology and Stem Cell Research2008-22072020-07-0114310.18502/ijhoscr.v14i3.3725Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT)Mani Ramzi0Nasrin Namdari1Shirin Haghighat2Hourvash Haghighinejad3Hematology and Bone Marrow Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Hematology, Hematology Research Center, Medical Oncology and Stem Cell Transplantation, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Family Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Background: Busulfan (BU) in combination with cyclophosphamide (CY) is used as an effective conditioning regimen in hematopoietic SCT. Busulfan, depletes glutathione level in liver and causes elevated levels of CY metabolites. Cyclophosphamide metabolites are highly toxic for sinusoidal endothelial cells and cause VOD/ SOS with high mortality rate. Materials and Methods: All adult patients with acute leukemia, who were candidates for myeloablative allogenic SCT admitted in Stem Cell Transplantation center of our center were enrolled in this prospective randomized clinical trial during 2 years. We tested the hypothesis that reverse administration from BU-CY (28 patients) to CY-BU group (27 patients) would reduce liver toxicity. Results: Liver function tests were significantly higher in BU-CY group between day -1 and +4 (p<0.05), but we do not have VOD/SOS in both groups. The incidence and severity of acute GVHD was higher in BU-CY group, but not statistically significant. Engraftment and mortality rate were not different. Conclusion: These data support the concept that CY-BU is associated with less liver toxicity, suggesting CY-BU is superior to BU-CY as conditioning. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1152allogeneic transplantconditioningbusulfancyclophosphamide |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mani Ramzi Nasrin Namdari Shirin Haghighat Hourvash Haghighinejad |
spellingShingle |
Mani Ramzi Nasrin Namdari Shirin Haghighat Hourvash Haghighinejad Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT) International Journal of Hematology-Oncology and Stem Cell Research allogeneic transplant conditioning busulfan cyclophosphamide |
author_facet |
Mani Ramzi Nasrin Namdari Shirin Haghighat Hourvash Haghighinejad |
author_sort |
Mani Ramzi |
title |
Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT) |
title_short |
Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT) |
title_full |
Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT) |
title_fullStr |
Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT) |
title_full_unstemmed |
Evaluation of Reversed Administration Order of Busulfan (BU) and Cyclophosphamide (CY) as Conditioning on Liver Toxicity in Allogenic Hematopoietic Stem Cell Transplantation (ALL-HSCT) |
title_sort |
evaluation of reversed administration order of busulfan (bu) and cyclophosphamide (cy) as conditioning on liver toxicity in allogenic hematopoietic stem cell transplantation (all-hsct) |
publisher |
Tehran University of Medical Sciences |
series |
International Journal of Hematology-Oncology and Stem Cell Research |
issn |
2008-2207 |
publishDate |
2020-07-01 |
description |
Background: Busulfan (BU) in combination with cyclophosphamide (CY) is used as an effective conditioning regimen in hematopoietic SCT. Busulfan, depletes glutathione level in liver and causes elevated levels of CY metabolites. Cyclophosphamide metabolites are highly toxic for sinusoidal endothelial cells and cause VOD/ SOS with high mortality rate.
Materials and Methods: All adult patients with acute leukemia, who were candidates for myeloablative allogenic SCT admitted in Stem Cell Transplantation center of our center were enrolled in this prospective randomized clinical trial during 2 years. We tested the hypothesis that reverse administration from BU-CY (28 patients) to CY-BU group (27 patients) would reduce liver toxicity.
Results: Liver function tests were significantly higher in BU-CY group between day -1 and +4 (p<0.05), but we do not have VOD/SOS in both groups. The incidence and severity of acute GVHD was higher in BU-CY group, but not statistically significant. Engraftment and mortality rate were not different.
Conclusion: These data support the concept that CY-BU is associated with less liver toxicity, suggesting CY-BU is superior to BU-CY as conditioning.
|
topic |
allogeneic transplant conditioning busulfan cyclophosphamide |
url |
https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1152 |
work_keys_str_mv |
AT maniramzi evaluationofreversedadministrationorderofbusulfanbuandcyclophosphamidecyasconditioningonlivertoxicityinallogenichematopoieticstemcelltransplantationallhsct AT nasrinnamdari evaluationofreversedadministrationorderofbusulfanbuandcyclophosphamidecyasconditioningonlivertoxicityinallogenichematopoieticstemcelltransplantationallhsct AT shirinhaghighat evaluationofreversedadministrationorderofbusulfanbuandcyclophosphamidecyasconditioningonlivertoxicityinallogenichematopoieticstemcelltransplantationallhsct AT hourvashhaghighinejad evaluationofreversedadministrationorderofbusulfanbuandcyclophosphamidecyasconditioningonlivertoxicityinallogenichematopoieticstemcelltransplantationallhsct |
_version_ |
1724425373350887424 |