The optimal conditioning regimen for allogeneic
hematopoietic stem cell transplantation (allo-HSCT) in acute
leukemia remains undefined. We evaluated the outcomes in 30 patients with acute
leukemia who underwent allo-HSCT from
human leukocyte antigen-matched donors after conditioning with
busulfan and
fludarabine (BuFlu). The regimen comprised injection of
busulfan 3.2 mg/kg daily on 4 consecutive days and
fludarabine 30 mg/m2 daily for 4 doses. All 30 patients achieved hematopoiesis reconstitution with full donor chimerism confirmed by short tandem repeat
DNA analysis. The most common regimen-related toxicity was
mucositis (86.7%), followed by
cytomegalovirus infection (80%). Serious regimen-related toxicities were rare. Acute
graft vs. host disease (aGVHD) was detected in 46.7% of the patients; 33.4% had grade I-II aGVHD and 13.3% had grade III-IV aGVHD. Chronic GVHD (cGVHD) was noted in 20% of the patients. The overall survival and disease-free survival rates were 66.7 and 53%, respectively, with a median follow-up of 25 months for surviving patients. Therefore, BuFlu was an effective conditioning regimen with a low rate of transplant-related adverse effects and increased antileukemic effects in patients with acute
leukemia undergoing allo-HSCT.