Abstract:
We examined pharmacokinetic-targeted IV busulfan (75-170 mg-m2, with target AUC of 3500-6000 μmol min) and fludarabine (40 mg-m2) × 4 days with rituximab (t-IV Bu-Flu + rituximab) 375 mg-m2 on days +1 and +8 followed by allogeneic hematopoietic cell transplantation in 19 patients (median age 56, range 35-68 years) with CD20+ lymphoid malignancies. Median time to neutrophil and platelet engraftment was 15 and 12 days. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 58percent (95percent confidence interval, CI 39-85percent), and chronic GVHD was 50percent (95percent CI 28-88percent). With a median follow up of 7 (range 1-31) months, overall response was observed in 15, and stable or progressive disease in 4. Overall survival at 1 year was 67percent. Engraftment, chimerism, and infectious complications did not differ significantly from a contemporaneous non-rituximab containing comparator group. The addition of rituximab 375 mg-m2 to t-IV Bu-Flu does not appear to adversely affect engraftment, donor chimerism, or increase the risk of infectious complications. © 2011 The Japanese Society of Hematology.