Unrelated-donor bone marrow transplantation with a conditioning regimen including fludarabine, busulfan, and 4 Gy total body irradiation

Yasushi Onishi, Shin Ichiro Mori, Shigeru Kusumoto, Kyoko Sugimoto, Daigo Akahane, Yuriko Morita-Hoshi, Sung Won Kim, Takahiro Fukuda, Yuji Heike, Ryuji Tanosaki, Kensei Tobinai, Yoichi Takaue

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12 Citations (Scopus)


We investigated the feasibility of reduced-intensity conditioning with 4 Gy total body irradiation, fludarabine (30 mg/m2 for 6 days), and busulfan (4 mg/kg for 2 days) for bone marrow transplantation from a serologically HLA-matched unrelated donor. Seventeen adult patients (median age, 55 years; range, 27-67 years) with various hematologic malignancies (6 in remission, 11 not in remission) were treated. Successful engraftment was achieved in all patients at a median of day 18 (range, day 14-35) after transplantation, although subsequent secondary graft failure was observed in 2 patients. The cumulative incidence of acute graft-versus-host disease (GVHD) of grades II to IV at day 100 was 48%. With a median follow-up of 286 days (range, 56-687 days), the rates of 1-year overall survival, 100-day nonrelapse mortality, and 1-year nonrelapse mortality were 41%, 14%, and 46%, respectively. Eleven patients died, and the causes of death were relapse (n = 4), pulmonary complications (n = 4), acute GVHD (n = 2), and sepsis (n = 1). The remaining 6 patients (at transplantation, 2 were in remission, and 4 were not in remission) are currently still in remission. These results suggest that this regimen reduces the risk of graft failure, but further studies are needed to ameliorate transplantation-related toxicities, primarily GVHD and/or pulmonary complications.

Original languageEnglish
Pages (from-to)256-263
Number of pages8
JournalInternational journal of hematology
Issue number3
Publication statusPublished - 2007 Apr
Externally publishedYes


  • Busulfan
  • Fludarabine
  • TBI
  • Unrelated donor bone marrow transplantation

ASJC Scopus subject areas

  • Hematology


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