Busulphan With Fludarabine Versus Busulphan Plus Cyclophosphamide As Conditioning Regimen For Myeloid Leukemia Patients Undergoing Allogeneic Stem Cell Transplantation:A Meta Analysis

Aim:The aim of the study was to compare the therapeutic efficacy and safety of busulphan with fludarabine(BU+FLU)versus busulphan plus cyclophosphamide(BU+CY)as conditioning regimen for patients with myeloid leukemia undergoing allogeneic stem cell transplantation(HSCT).Method:We searched some databases on computer and critically appraised all relevant articles(1990.01-2017.08).Comparative studies were evaluated on clinical therapeutic effects of BU+FLU and BU+CY regimens,and outcomes were calculated using the Stata 12.0.The hazard ratio(HR)effect with 95%confidence interval were used to assess the overall survival(OS).The odds risk(OR)with 95%confidence interval were used to caculate the incidence rate of nausea,mucositis,hepatic vein occlusive disease(VOD),organ toxicity,infection,acute Graft-Versus-Host-Disease,(aGVHD),chronic Graft-Versus-Host-Disease(cGVHD).Result:Nine trials totaling 827 patients have been assessed.Two of them are randomized controlled trials,and the rest of them are clinical trials.Pooled comparisons of studies indicated that for patients with myeloid leukemia,the BU+FLU regimen lead to lower rates of nausea(P=0.031),cardiac toxicity and liver toxicity(P=0.009,P=0.004).The BU+FLU regimen had a higher rate of 5 years overall surival(P=0.000).Conclusion:Our meta-analysis confirmed that BU+FLU regimen can be a better chioce for patients with myeloid leukemia,instead of BU+CY regimen.