Efficacy And Safety Of Idabicin Instead Of Cytarabine As A Myeloablative Conditioning Regimen For Allogeneic Hematopoietic Stem Cell Transplantation For Treatment Of Myeloid Malignancies:A Retrospective Study

Objective To investigate the feasibility of idabicin(IDA)instead of cytarabine(Ara-C)in modified busulfan(Bu)/cyclophosphamide(Cy)regimen as a new myeloablative conditioning regimen in allogeneic hematopoietic stem cell transplantation(HSCT)for myeloid malignancie2 patientsMethods From December 2015 to October 2019,68 unselected patients with myeloid malignancies received allo-HSCT in our center,of which 35 patients received Bu+Flu±Cy+Ara-C regimen,33 received Bu+Flu±Cy+IDA regimen.The main outcome measures were regimen-related toxicity,engraftment,relapse,disease free survival,and overall survival.Results All patients achieved neutrophil engraftment except one in IDA group.The incidence of oral ulcers and diarrhea in the IDA group was higher than in the Ara-C group without statistically significant difference(75.8%vs.60.0%[P=0.165],63.6%vs.40.0%[P=0.051],respectively).The relapse rates of the Ara-c group and the IDA group were 25.7%vs.and 15.2%,respectively(P=0.372).The 2-year overall survival rates were(59.9±8.3)%vs.(78.8±7.1)%(P=0.288)and 2-year disease free survival rates were(67.9±8.5)%vs.(83.1±6.9)%(P=0.263)were comparable between Ara-c group and IDA group.Conclusions Idabicin(IDA)instead of cytarabine(Ara-C)as a new myeloablative conditioning regimen could reduce relapse and improve survival without increasing retreatment-related toxicity and adverse reactions.