Allogeneic stem cell transplant for multiple myeloma & myelofibrosis with split-dose busulfan, fludarabine & cyclophosphamide

Andrew D Trunk; Sagar S Patel; Josef T Prchal; Douglas W Sborov; Axel R Zander; Catherine J Lee

doi:10.1016/j.lrr.2023.100388

Allogeneic stem cell transplant for multiple myeloma & myelofibrosis with split-dose busulfan, fludarabine & cyclophosphamide

Leuk Res Rep. 2023 Aug 26:20:100388. doi: 10.1016/j.lrr.2023.100388. eCollection 2023.

Authors

Andrew D Trunk¹, Sagar S Patel¹, Josef T Prchal¹, Douglas W Sborov¹, Axel R Zander¹, Catherine J Lee¹

Affiliation

¹ Transplant and Cellular Therapy Program, Huntsman Cancer Institute, University of Utah, USA.

Abstract

Allogeneic stem cell transplant can have high morbidity and mortality in patients with myelofibrosis (MF) and multiple myeloma (MM). This phase 2 study used a novel myeloablative regimen of split-dose busulfan, fludarabine, and then post-transplant cyclophosphamide. Four patients with MF and 2 with MM were enrolled. At 1 year, non-relapse mortality was 33.3%, and overall survival was 50%. Incidence of acute and chronic GVHD was 33.3% and 16.7%, respectively. Those surviving beyond 1 year (MF = 1, MM = 2) had durable remissions with a median follow-up of 42 months. This small study demonstrates relative safety & favorable key outcomes using this novel approach.

Keywords: Allogeneic transplant; Conditioning; Multiple myeloma; Myelofibrosis; Preparative.