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    Comparison of fludarabine-melphalan and fludarabine-treosulfan as conditioning prior to allogeneic hematopoietic cell transplantation-a registry study on behalf of the EBMT Acute Leukemia Working Party

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    Authors
    Duque-Afonso, J.
    Finke, J.
    Labopin, M.
    Craddock, C.
    Protheroe, R.
    Kottaridis, P.
    Tholouli, E.
    Byrne, J. L.
    Orchard, K.
    Salmenniemi, U.
    Hilgendorf, I.
    Hunter, H.
    Nicholson, E.
    Bloor, Adrian
    Snowden, J. A.
    Verbeek, M.
    Clark, A.
    Savani, B. N.
    Spyridonidis, A.
    Nagler, A.
    Mohty, M.
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    Affiliation
    Department of Hematology/Oncology, Faculty of Medicine, University of Freiburg Medical Center, Freiburg, Germany
    Issue Date
    2022
    
    Metadata
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    Abstract
    In recent years considerable variations in conditioning protocols for allogeneic hematopoietic cell transplantation (allo-HCT) protocols have been introduced for higher efficacy, lower toxicity, and better outcomes. To overcome the limitations of the classical definition of reduced intensity and myeloablative conditioning, a transplantation conditioning intensity (TCI) score had been developed. In this study, we compared outcome after two frequently used single alkylator-based conditioning protocols from the intermediate TCI score category, fludarabine/melphalan 140 mg/m2 (FluMel) and fludarabine/treosulfan 42 g/m2 (FluTreo) for patients with acute myeloid leukemia (AML) in complete remission (CR). This retrospective analysis from the registry of the Acute Leukemia Working Party (ALWP) of the European Society of Bone Marrow Transplantation (EBMT) database included 1427 adult patients (median age 58.2 years) receiving either Flu/Mel (n = 1005) or Flu/Treo (n = 422). Both groups showed similar 3-year overall survival (OS) (54% vs 51.2%, p value 0.49) for patients conditioned with FluMel and FluTreo, respectively. However, patients treated with FluMel showed a reduced 3-year relapse incidence (32.4% vs. 40.4%, p value < 0.001) and slightly increased non-relapse mortality (NRM) (25.7% vs. 20.2%, p value = 0.06) compared to patients treated with FluTreo. Our data may serve as a basis for further studies examining the role of additional agents/ intensifications in conditioning prior to allo-HCT.
    Citation
    Duque-Afonso J, Finke J, Labopin M, Craddock C, Protheroe R, Kottaridis P, et al. Comparison of fludarabine–melphalan and fludarabine–treosulfan as conditioning prior to allogeneic hematopoietic cell transplantation—a registry study on behalf of the EBMT Acute Leukemia Working Party. Bone Marrow Transplantation. Springer Science and Business Media LLC; 2022.
    Journal
    Bone Marrow Transplantation
    URI
    http://hdl.handle.net/10541/625311
    DOI
    10.1038/s41409-022-01646-1
    PubMed ID
    35568756
    Additional Links
    https://dx.doi.org/10.1038/s41409-022-01646-1
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1038/s41409-022-01646-1
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