conditioning regimens in allogeneic hematopoietic stem cell transplantation do not fit all: adjusting bucy2 in mexico to improve outcomes in acute myeloid leukemia (aml) and myelodysplastic syndrome (mds)

Background: conditioning regimens are critical for allogeneic hematopoietic cell transplantation (allo-hct). after unfavorable results using bucy2 at the beginning of our hct program, a restructuring was made with the consequent development of a modified hct method including a reduced conditioning regimen. the objective of this study was to describe the outcomes using reduced bucy2 (rbucy2) in allo-hct. materials and methods: data from 38 consecutive patients with acute myeloid leukemia (aml) and myelodysplastic syndrome (mds) who underwent allo-hct conditioned with rbucy2 in a 21-year period were retrospectively analyzed. results: most patients were males (53%) and the median age was 35 years. the most common disease was myelodysplastic syndrome (55%). toxicity grades iii-iv were observed in 44%; and acute and chronic graft versus-host disease were observed in 26% and 34%, respectively; the median follow-up was 26 months; 30- day non-relapse mortality (nrm) was 3%, and 1 and 2-year nrm were 8%. ten-year overall survival (os) was 60%, and 86%, for aml and mds, respectively. conclusion: our rbucy2 maintains a myeloablative effect, along with immunosuppression for fast engraftment and more importantly, this regimen reduces grades iii-iv acute gvhd and nrm in allo-hct and improves the os and it appears to be an option for low and middle-income countries.