Research Highlights

Drug option better than irradiation for leukaemia

Published online 3 October 2013

Aisha El-Awady

The two most widely used ways to deplete the body of bone marrow in preparation for a bone marrow transplant are the drug cyclophosphamide combined with either total body irradiation or another drug, busulfan.

In a study led by Edward A. Copelan from Levine Cancer Institute in North Carolina and including Mahmoud Aljurf from King Faisal Specialist Hospital Center and Research in Riyadh, researchers found that combining cyclophosphamide with intravenous busulfan gives better results than a combination of cyclophosphamide with total body irradiation, publishing their findings in Blood.

The team compared data from 1,230 patients with acute myeloid leukaemia in first remission who had received haematopoietic cell transplant from a genetically matched sibling or unrelated donor following preparation with one of the two regimens.

Individuals who had received intravenous busulfan had significantly fewer cases of treatment-related deaths and fewer relapses occurring more than one year after the transplant. The patients also had better survival rates, as well as a lower chance of treatment failure.

"In the absence of a randomized trial, this study strongly suggests that for patients with acute myeloid leukaemia, in combination with cyclophosphamide, busulfan is safer and more effective than total body irradiation," says Copelan.


  1. Copelan, E.A. et al. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared to TBI. Blood (2013) doi:10.1182/blood-2013-07-514448