Conditioning with Fludarabine-Busulfan versus Busulfan-Cyclophosphamide Is Associated with Lower aGVHD and Higher Survival but More Extensive and Long Standing Bone Marrow Damage

Biomed Res Int. 2016:2016:3071214. doi: 10.1155/2016/3071214. Epub 2016 Oct 24.

Abstract

Acute graft-versus-host disease (aGVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and a major cause of nonrelapse mortality after allo-HSCT. A conditioning regimen plays a pivotal role in the development of aGVHD. To provide a platform for studying aGVHD and evaluating the impact of different conditioning regimens, we established a murine aGVHD model that simulates the clinical situation and can be conditioned with Busulfan-Cyclophosphamide (Bu-Cy) and Fludarabine-Busulfan (Flu-Bu). In our study, BALB/c mice were conditioned with Bu-Cy or Flu-Bu and transplanted with 2 × 107 bone marrow cells and 2 × 107 splenocytes from either allogeneic (C57BL/6) or syngeneic (BALB/c) donors. The allogeneic recipients conditioned with Bu-Cy had shorter survivals (P < 0.05), more severe clinical manifestations, and higher hepatic and intestinal pathology scores, associated with increased INF-γ expression and diminished IL-4 expression in serum, compared to allogeneic recipients conditioned with Flu-Bu. Moreover, higher donor-derived T-cell infiltration and severely impaired B-cell development were seen in the bone marrow of mice, exhibiting aGVHD and conditioned with Flu-Bu. Our study showed that the conditioning regimen with Bu-Cy resulted in more severe aGVHD while the Flu-Bu regimen was associated with more extensive and long standing bone marrow damage.

MeSH terms

  • Animals
  • Bone Marrow Cells / drug effects
  • Bone Marrow Transplantation
  • Busulfan / administration & dosage*
  • Cyclophosphamide / administration & dosage*
  • Disease Models, Animal
  • Drug Combinations
  • Gene Expression Regulation / drug effects
  • Graft vs Host Disease / drug therapy*
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / immunology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Interferon-gamma / biosynthesis
  • Interleukin-4 / blood
  • Mice
  • T-Lymphocytes / drug effects
  • Transplantation, Homologous / adverse effects
  • Vidarabine / administration & dosage
  • Vidarabine / analogs & derivatives*

Substances

  • Drug Combinations
  • Interleukin-4
  • Interferon-gamma
  • Cyclophosphamide
  • Vidarabine
  • Busulfan
  • fludarabine