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

被引：10

作者：

Duque-Afonso, Jesus ^{[1
]}

Finke, Juergen ^{[1
]}

Labopin, Myriam ^{[2
]}

Craddock, Charles ^{[3
]}

Protheroe, Rachel ^{[4
]}

Kottaridis, Panagiotis ^{[5
]}

Tholouli, Eleni ^{[6
]}

Byrne, Jenny L. ^{[7
]}

Orchard, Kim ^{[8
]}

Salmenniemi, Urpu ^{[9
]}

Hilgendorf, Inken ^{[10
]}

Hunter, Hannah ^{[11
]}

Nicholson, Emma ^{[12
]}

Bloor, Adrian ^{[13
]}

Snowden, John A. ^{[14
]}

Verbeek, Mareike ^{[15
]}

Clark, Andrew ^{[16
]}

Savani, Bipin N. ^{[17
]}

Spyridonidis, Alexandros ^{[18
]}

Nagler, Arnon ^{[19
]}

Mohty, Mohamad ^{[20
]}

机构：

[1] Univ Freiburg, Dept Hematol Oncol, Fac Med, Med Ctr, Freiburg, Germany

[2] Hop St Antoine, EBMT Paris Study Off, Paris, France

[3] Queen Elizabeth Hosp Birmingham, Birmingham Ctr Cellular Therapy & Transplantat, Birmingham, W Midlands, England

[4] Univ Hosp Bristol & Weston NHS Fdn Trust, Bristol, Avon, England

[5] Univ Coll London Hosp, Dept Haematol, London, England

[6] Manchester Royal Infirm, Clin Haematol Dept, Manchester, Lancs, England

[7] Univ Nottingham, Hucknall Rd, Nottingham, England

[8] Univ Hosp Southampton NHS Fdn Trust, Wessex Blood & Marrow Transplant & Cellular Thera, Southampton, Hants, England

[9] HUCH Comprehens Canc Ctr, Stem Cell Transplantat Unit, Helsinki, Finland

[10] Univ Klinikum Jena, Klin Innere Med 2, Abt Hamatol & Onkol, Klinikum 1, Jena, Germany

[11] Univ Hosp Plymouth NHS Trust, Derriford Hosp, Plymouth, Devon, England

[12] Royal Marsden Hosp, Dept Haematol, London, England

[13] Univ Manchester, Christie NHS Fdn Trust, Stem Cell Transplantat Unit, Manchester, Lancs, England

[14] Royal Hallamshire Hosp, Sheffield Teaching Hosp NHS Trust, Sheffield, S Yorkshire, England

[15] TU, Klinikum Rechts Isar, Med Klin 3, Munich, Germany

[16] Gartnaval Gen Hosp, West Scotland Canc Ctr, Bone Marrow Transplant Unit, Beatson, Glasgow, Lanark, Scotland

[17] Vanderbilt Univ, Med Ctr, Div Hematol & Oncol, Nashville, TN USA

[18] Univ Hosp Patras, Patras, Greece

[19] Chaim Sheba Med Ctr, Hematol Div, Tel Hashomer, Israel

[20] Sorbonne Univ, St Antoine Hosp, AP HP, INSERM,UMRs 938, Paris, France

来源：

BONE MARROW TRANSPLANTATION | 2022年 / 57卷 / 08期

关键词：

ACUTE MYELOID-LEUKEMIA; HOST-DISEASE PROPHYLAXIS; MYELODYSPLASTIC SYNDROME; OPEN-LABEL; INTENSITY; REGIMEN; GLOBULIN; BLOOD; MALIGNANCIES;

D O I：

10.1038/s41409-022-01646-1

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

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/m(2) (FluMel) and fludarabine/treosulfan 42 g/m(2) (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.

引用

页码：1269 / 1276

页数：8

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