Comparison of Allogeneic Stem Cell Transplant Conditioning Regimens in AML, MDS, and CLL

    January 2018 in “ General internal medicine and clinical innovations ”
    Michele N. West
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    TLDR Busulfan/cyclophosphamide and total bone irradiation are equally effective for AML transplants.
    The review compared busulfan/cyclophosphamide combination therapy with total bone irradiation for allogeneic stem cell transplantation in acute myeloid leukemia (AML) patients. Analyzing 9 studies with 15,004 HLA-matched participants, it found no significant difference in overall survival and disease-free survival between the two regimens (effect size: 0.20; relative risk: 1.27; 95% CI 0.80-2.01, p=0.36). Both regimens had serious adverse effects, including graft versus host disease, alopecia, interstitial pneumonia, and cataract. The conclusion that busulfan/cyclophosphamide does not improve prognosis over total bone irradiation was questioned due to study limitations and the inclusion of various leukemic conditions.
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