Reduced intensity versus non-myeloablative conditioning regimen for haploidentical transplantation and post-transplantation cyclophosphamide in complete remission acute myeloid leukemia: a study from the ALWP of the EBMT

The optimal conditioning regimen prior haploidentical stem cell transplantation (Haplo-SCT) with post transplantation cyclophosphamide (PT-Cy) for acute myeloid leukemia (AML) remains unknown. A non-myeloablative conditioning (NMAC) regimen (cyclophosphamide + fludarabine + TBI 2 Gy [CyFluTBI]) is a...

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Published in:Bone marrow transplantation (Basingstoke) 2022-09, Vol.57 (9), p.1421-1427
Main Authors: Devillier, Raynier, Galimard, Jacques-Emmanuel, Labopin, Myriam, Blaise, Didier, Raiola, Anna Maria, Pavlu, Jiri, Castagna, Luca, Socié, Gerard, Chalandon, Yves, Martino, Massimo, Stölzel, Friedrich, Bug, Gesine, Bruno, Benedetto, Vrhovac, Radovan, Charbonnier, Amandine, Olivieri, Attilio, Bay, Jacques-Olivier, Arroyo, Herrera, Yakoub-Agha, Ibrahim, Avenoso, Daniele, Neubauer, Andreas, Nguyen, Stéphanie, Forcade, Edouard, Brissot, Eolia, Savani, Bipin, Nagler, Arnon, Mohty, Mohamad
Format: Article
Language:English
Subjects:
692/699/1541/1990/283/1897
692/700/565/2319
Acute myeloid leukemia
Bone marrow
Busulfan
Cell Biology
Conditioning
Cyclophosphamide
Fludarabine
Hematology
Internal Medicine
Leukemia
Life Sciences
Medicine
Medicine & Public Health
Public Health
Remission
Stem cell transplantation
Stem Cells
Toxicity
Transplantation
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Summary:The optimal conditioning regimen prior haploidentical stem cell transplantation (Haplo-SCT) with post transplantation cyclophosphamide (PT-Cy) for acute myeloid leukemia (AML) remains unknown. A non-myeloablative conditioning (NMAC) regimen (cyclophosphamide + fludarabine + TBI 2 Gy [CyFluTBI]) is a safe approach, but relapse incidence remains high in this setting. Alternatively, a reduced intensity conditioning (RIC) regimen combining thiotepa and reduced-dose busulfan with fludarabine (TBF) may decrease AML relapse. However, an excess of toxicity may counterbalance this potential benefit. We retrospectively compared CyFluTBI vs. TBF in CR AML patients who underwent Haplo-SCT with PT-Cy, in two different populations based on age. We analyzed 490 patients. In patients aged
ISSN:0268-3369
1476-5365
DOI:10.1038/s41409-022-01674-x