Increased risk of gastrointestinal acute GVHD following the addition of melphalan to busulfan/cyclophosphamide conditioning

• Published in: Pediatric transplantation 2013-05, Vol.17 (3), p.285-293
• Main Authors: Mårtensson, T., Priftakis, P., Casswall, T., Ringdén, O., Mattsson, J., Remberger, M., Hassan, M., Gustafsson, B.
• Format: Article
• Language: English
• Subjects: Adolescent; busulfan; Busulfan - administration & dosage; Busulfan - adverse effects; Child; Child, Preschool; Cyclophosphamide - adverse effects; Female; Gastrointestinal Tract - drug effects; Graft vs Host Disease - diagnosis; graft-versus-host disease; gut toxicity; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Humans; Infant; juvenile myelomonocytic leukemia; Leukemia, Myelomonocytic, Acute - therapy; Male; Medicin och hälsovetenskap; melphalan; Melphalan - administration & dosage; Melphalan - adverse effects; myelodysplastic syndrome; Myelodysplastic Syndromes - therapy; Retrospective Studies; Risk Factors; Transplantation Conditioning - adverse effects; Transplantation Conditioning - methods; Treatment Outcome
• ISSN: 1397-3142; 1399-3046; 1399-3046
• DOI: 10.1111/petr.12061

Risk factors associated with the development of aGVHD in the gastrointestinal tract have not been studied in depth. We retrospectively assessed 25 pediatric patients with MDS and JMML and compared the treatment outcome of two different conditioning regimens. Seventeen children (68%) underwent conditioning with busulfan (Bu), cyclophosphamide (Cy), and melphalan (Mel) and eight children (32%) with Bu and Cy. Gastrointestinal aGVHD stages II–IV (day 0–100) were observed in 47% (eight of 17) of the patients in the BuCyMel group and in none (0 of 8) in the BuCy group (p