Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy
In the era of precision medicine, the impact of personalized dosing of busulfan is not clear. We undertook a retrospective analysis of 78 patients with myeloid malignancies who received fludarabine and busulfan (FluBu4) with or without measuring Bu pharmacokinetics (Bu PK) and those who received bus...
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| Format: | Article |
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Wiley
2017-01-01
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| Series: | Advances in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2017/8690416 |
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| author | Shatha Farhan Michael Bazydlo Klodiana Neme Nancy Mikulandric Edward Peres Nalini Janakiraman |
| author_facet | Shatha Farhan Michael Bazydlo Klodiana Neme Nancy Mikulandric Edward Peres Nalini Janakiraman |
| author_sort | Shatha Farhan |
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| description | In the era of precision medicine, the impact of personalized dosing of busulfan is not clear. We undertook a retrospective analysis of 78 patients with myeloid malignancies who received fludarabine and busulfan (FluBu4) with or without measuring Bu pharmacokinetics (Bu PK) and those who received busulfan with cyclophosphamide (BuCy). Fifty-five patients received FluBu4, of whom 21 had Bu PK measured, and 23 patients received BuCy. Total donor cell chimerism showed that the percentage of patients maintaining 100% donor chimerism on day 100 was 66.7%, 38.2%, and 73.9% in the FluBu4 with PK, FluBu4 with no PK, and BuCy, respectively (P = .001). Patients who had decreasing donor chimerism by day 100 were 23.8%, 52.9%, and 26.1% in the FluBu4 with PK, FluBu4 with no PK, and BuCy, respectively (P = .04). Bu PK group had fewer patients with less than 95% donor chimerism on day 30, which was not statistically significant, 5% (FluBu4 PK), 31% (FluBu4 with no PK), and 21% (BuCy) (P = .18). Survival distributions were not statistically significant (P = .11). Thus, personalized drug dosing can impact donor chimerism in myeloid malignancies. This will need to be examined in larger retrospective multicenter studies and prospective clinical trials. |
| format | Article |
| id | doaj-art-4ca7eea3ba1149e585821f98e96505bc |
| institution | Kabale University |
| issn | 1687-9104 1687-9112 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
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| series | Advances in Hematology |
| spelling | doaj-art-4ca7eea3ba1149e585821f98e96505bc2025-02-03T05:52:36ZengWileyAdvances in Hematology1687-91041687-91122017-01-01201710.1155/2017/86904168690416Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCyShatha Farhan0Michael Bazydlo1Klodiana Neme2Nancy Mikulandric3Edward Peres4Nalini Janakiraman5Stem Cell Transplant Program, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USADivision of Biostatistics, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USADivision of Pharmacy, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USADivision of Pharmacy, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USAStem Cell Transplant Program, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USAStem Cell Transplant Program, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USAIn the era of precision medicine, the impact of personalized dosing of busulfan is not clear. We undertook a retrospective analysis of 78 patients with myeloid malignancies who received fludarabine and busulfan (FluBu4) with or without measuring Bu pharmacokinetics (Bu PK) and those who received busulfan with cyclophosphamide (BuCy). Fifty-five patients received FluBu4, of whom 21 had Bu PK measured, and 23 patients received BuCy. Total donor cell chimerism showed that the percentage of patients maintaining 100% donor chimerism on day 100 was 66.7%, 38.2%, and 73.9% in the FluBu4 with PK, FluBu4 with no PK, and BuCy, respectively (P = .001). Patients who had decreasing donor chimerism by day 100 were 23.8%, 52.9%, and 26.1% in the FluBu4 with PK, FluBu4 with no PK, and BuCy, respectively (P = .04). Bu PK group had fewer patients with less than 95% donor chimerism on day 30, which was not statistically significant, 5% (FluBu4 PK), 31% (FluBu4 with no PK), and 21% (BuCy) (P = .18). Survival distributions were not statistically significant (P = .11). Thus, personalized drug dosing can impact donor chimerism in myeloid malignancies. This will need to be examined in larger retrospective multicenter studies and prospective clinical trials.http://dx.doi.org/10.1155/2017/8690416 |
| spellingShingle | Shatha Farhan Michael Bazydlo Klodiana Neme Nancy Mikulandric Edward Peres Nalini Janakiraman Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy Advances in Hematology |
| title | Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy |
| title_full | Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy |
| title_fullStr | Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy |
| title_full_unstemmed | Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy |
| title_short | Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy |
| title_sort | chimerism in myeloid malignancies following stem cell transplantation using flubu4 with and without busulfan pharmacokinetics versus bucy |
| url | http://dx.doi.org/10.1155/2017/8690416 |
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