{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:53:10Z","timestamp":1770749590944,"version":"3.50.0"},"reference-count":31,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Natural Science Foundation of Jiangsu Province","award":["BK20161205"],"award-info":[{"award-number":["BK20161205"]}]},{"name":"Natural Science Foundation of Jiangsu Province","award":["BK20160342"],"award-info":[{"award-number":["BK20160342"]}]},{"name":"Natural Science Foundation of Jiangsu Province","award":["81730003"],"award-info":[{"award-number":["81730003"]}]},{"name":"Natural Science Foundation of Jiangsu Province","award":["2017 YFA0104502"],"award-info":[{"award-number":["2017 YFA0104502"]}]},{"name":"Natural Science Foundation of Jiangsu Province","award":["2017 ZX09304021"],"award-info":[{"award-number":["2017 ZX09304021"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["BK20161205"],"award-info":[{"award-number":["BK20161205"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["BK20160342"],"award-info":[{"award-number":["BK20160342"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81730003"],"award-info":[{"award-number":["81730003"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2017 YFA0104502"],"award-info":[{"award-number":["2017 YFA0104502"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2017 ZX09304021"],"award-info":[{"award-number":["2017 ZX09304021"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Key R&amp;D Program of China","award":["BK20161205"],"award-info":[{"award-number":["BK20161205"]}]},{"name":"National Key R&amp;D Program of China","award":["BK20160342"],"award-info":[{"award-number":["BK20160342"]}]},{"name":"National Key R&amp;D Program of China","award":["81730003"],"award-info":[{"award-number":["81730003"]}]},{"name":"National Key R&amp;D Program of China","award":["2017 YFA0104502"],"award-info":[{"award-number":["2017 YFA0104502"]}]},{"name":"National Key R&amp;D Program of China","award":["2017 ZX09304021"],"award-info":[{"award-number":["2017 ZX09304021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Melphalan was poorly available in mainland China. The aim of this study is to explore the dose-adjusted busulfan\/cyclophosphamide (BU\/CY) as an alternative regimen in auto stem cell transplantation (ASCT) for multiple myeloma (MM). Methods: A total of 105 newly diagnosed MM patients undergoing ASCT during May 2012 and August 2017 were retrospectively analyzed. The BU\/CY regimen was applied to 64 patients. Busulfan (9.6 mg\/kg or 8.0 mg\/kg in total) and cyclophosphamide (3.6 g\/m2 or 3.0 g\/m2 in total) were administered according to the creatinine clearance rate (CCR). A high-dose melphalan (HDMEL) regimen (200 mg\/m2) was given to the other 41 patients. Results: At a median follow-up of 65 (1~119) months, estimated overall survival (OS) and progression-free survival (PFS) at 104 months in the BU\/CY and HDMEL groups were 35.6% vs. 20.5% (p = 0.263) and 20.2% vs. 2.4% (p = 0.035), respectively. The median overall survival (OS) and PFS of the HDMEL and BU\/CY groups were 55 vs. 70.5 months and 26 vs. 46.5 months, respectively. In multivariate analysis, the BU\/CY regimen was found to be the only protective factor for PFS. No lethal toxicity was found in the BU\/CY group, and treatment-related mortality (TRM) in 100 days was similar to the HDMEL group. Conclusions: MM patients may also benefit from the dose-adjusted BU\/CY regimen.<\/jats:p>","DOI":"10.3390\/jcm12196239","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T01:51:14Z","timestamp":1695865874000},"page":"6239","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Busulfan\/Cyclophosphamide Compared with Melphalan as a Conditioning Regimen for Autologous Transplantation of Multiple Myeloma: A Long-Term Assessment"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2992-789X","authenticated-orcid":false,"given":"Shiyuan","family":"Zhou","sequence":"first","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingying","family":"Zhai","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingzhi","family":"Yan","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolan","family":"Shi","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Shang","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6312-3863","authenticated-orcid":false,"given":"Depei","family":"Wu","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengcheng","family":"Fu","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Jin","sequence":"additional","affiliation":[{"name":"Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China"},{"name":"Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou 215006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1182\/blood-2005-08-3449","article-title":"Risk of monoclonal gammopathy of undetermined significance (MGUS) and subsequent multiple myeloma among African American and white veterans in the United States","volume":"107","author":"Landgren","year":"2006","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41408-019-0205-9","article-title":"Current status of autologous stem cell transplantation for multiple myeloma","volume":"9","author":"Bazarbachi","year":"2019","journal-title":"Blood Cancer J."},{"key":"ref_3","first-page":"220","article-title":"Autologous stem cell transplantation in multiple myeloma","volume":"62","author":"Ricciuti","year":"2020","journal-title":"Panminerva Medica"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1182\/blood.V99.3.731","article-title":"Comparison of 200 mg\/m(2) melphalan and 8 Gy total body irradiation plus 140 mg\/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: Final analysis of the Intergroupe Francophone du My\u00e9lome 9502 randomized trial","volume":"99","author":"Moreau","year":"2002","journal-title":"Blood"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1200\/JCO.18.02096","article-title":"Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline","volume":"37","author":"Mikhael","year":"2019","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.3389\/fonc.2019.01513","article-title":"Prevalence and Incidence of Multiple Myeloma in Urban Area in China: A National Population-Based Analysis","volume":"9","author":"Wang","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1038\/s41409-021-01431-6","article-title":"Hematopoietic stem cell transplantation activity in China 2019: A report from the Chinese Blood and Marrow Transplantation Registry Group","volume":"56","author":"Xu","year":"2021","journal-title":"Bone Marrow Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.bbmt.2008.12.489","article-title":"Busulfan in hematopoietic stem cell transplantation","volume":"15","author":"Ciurea","year":"2009","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.3324\/haematol.2010.028027","article-title":"Busulfan 12 mg\/kg plus melphalan 140 mg\/m2 versus melphalan 200 mg\/m2 as conditioning regimens for autologous transplantation in newly diagnosed multiple myeloma patients included in the PETHEMA\/GEM2000 study","volume":"95","author":"Lahuerta","year":"2010","journal-title":"Haematologica"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"105","DOI":"10.5045\/br.2018.53.2.105","article-title":"Busulfan plus melphalan versus high-dose melphalan as conditioning regimens in autologous stem cell transplantation for newly diagnosed multiple myeloma","volume":"53","author":"Byun","year":"2018","journal-title":"Blood Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1634\/theoncologist.2012-0384","article-title":"Efficacy and safety of busulfan-based conditioning regimens for multiple myeloma","volume":"18","author":"Reece","year":"2013","journal-title":"Oncologist"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1186\/s12935-021-02313-z","article-title":"Long-term outcomes of busulfan plus melphalan-based versus melphalan 200 mg\/m(2) conditioning regimens for autologous hematopoietic stem cell transplantation in patients with multiple myeloma: A systematic review and meta-analysis","volume":"21","author":"Gao","year":"2021","journal-title":"Cancer Cell Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/00029330-200703020-00005","article-title":"Modified conditioning regimen busulfan-cyclophosphamide followed by allogeneic stem cell transplantation in patients with multiple myeloma","volume":"120","author":"Zhang","year":"2007","journal-title":"Chin. Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1002\/cncr.20294","article-title":"Comparison of high-dose melphalan with a more intensive regimen of thiotepa, busulfan, and cyclophosphamide for patients with multiple myeloma","volume":"100","author":"Anagnostopoulos","year":"2004","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1016\/j.leukres.2006.09.021","article-title":"High-dose melphalan versus busulfan, cyclophosphamide, and etoposide as preparative regimens for autologous stem cell transplantation in patients with multiple myeloma","volume":"31","author":"Benson","year":"2007","journal-title":"Leuk. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1038\/bmt.2008.298","article-title":"Autologous SCT with a dose-reduced BU and CY regimen in older patients with non-Hodgkin\u2019s lymphoma","volume":"43","author":"Yusuf","year":"2009","journal-title":"Bone Marrow Transplant."},{"key":"ref_17","first-page":"1618","article-title":"Busulfan Combined with Cyclophosphamide as the Conditioning Regimen in Patients with Multiple Myeloma Treated by Autologous Hematopoietic Stem Cell Transplantation","volume":"23","author":"Jin","year":"2015","journal-title":"Zhongguo Shi Yan Xue Ye Xue Za Zhi"},{"key":"ref_18","first-page":"1831","article-title":"Application of Conditioning Regimen with Busulfan and Cyclophosphamide in Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma","volume":"29","author":"Xu","year":"2021","journal-title":"Zhongguo Shi Yan Xue Ye Xue Za Zhi"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3412","DOI":"10.1200\/JCO.2005.04.242","article-title":"International staging system for multiple myeloma","volume":"23","author":"Greipp","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1002\/1097-0142(197509)36:3<842::AID-CNCR2820360303>3.0.CO;2-U","article-title":"A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival","volume":"36","author":"Durie","year":"1975","journal-title":"Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1038\/sj.leu.2404284","article-title":"International uniform response criteria for multiple myeloma","volume":"20","author":"Durie","year":"2006","journal-title":"Leukemia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.blre.2007.07.001","article-title":"Management of multiple myeloma: The changing landscape","volume":"21","author":"Reece","year":"2007","journal-title":"Blood Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1038\/s41409-020-01043-6","article-title":"Melphalan pharmacokinetics and transplant related toxicity during autologous stem cell transplantation","volume":"56","author":"Sahin","year":"2021","journal-title":"Bone Marrow Transplant."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e266","DOI":"10.1016\/S2352-3026(19)30023-7","article-title":"Conditioning with busulfan plus melphalan versus melphalan alone before autologous haemopoietic cell transplantation for multiple myeloma: An open-label, randomised, phase 3 trial","volume":"6","author":"Bashir","year":"2019","journal-title":"Lancet Haematol."},{"key":"ref_26","first-page":"131","article-title":"Phase I-II study of busulfan and cyclophosphamide conditioning for transplantation in advanced multiple myeloma","volume":"14","author":"Schiller","year":"1994","journal-title":"Bone Marrow Transplant."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/j.1365-2141.2004.04837.x","article-title":"Favourable results with a single autologous stem cell transplant following conditioning with busulphan and cyclophosphamide in patients with multiple myeloma","volume":"124","author":"Toor","year":"2004","journal-title":"Br. J. Haematol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1038\/bmt.2008.446","article-title":"BU and CY as conditioning regimen for autologous transplant in patients with multiple myeloma","volume":"44","author":"Talamo","year":"2009","journal-title":"Bone Marrow Transplant."},{"key":"ref_29","first-page":"313","article-title":"Busulfan, cyclophosphamide and etoposide as conditioning for autologous stem cell transplantation in multiple myeloma","volume":"34","author":"Zhang","year":"2013","journal-title":"Zhonghua Xue Ye Xue Za Zhi"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"3871","DOI":"10.1182\/blood-2013-08-519009","article-title":"Prospective cohort study comparing intravenous busulfan to total body irradiation in hematopoietic cell transplantation","volume":"122","author":"Bredeson","year":"2013","journal-title":"Blood"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e526","DOI":"10.1016\/S2352-3026(16)30114-4","article-title":"Association of busulfan exposure with survival and toxicity after haemopoietic cell transplantation in children and young adults: A multicentre, retrospective cohort analysis","volume":"3","author":"Bartelink","year":"2016","journal-title":"Lancet Haematol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6239\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:00:10Z","timestamp":1760130010000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,27]]},"references-count":31,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196239"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196239","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,27]]}}}