Fludarabine/TBI 8 Gy versus fludarabine/treosulfan conditioning in patients with AML in first complete remission: a study from the Acute Leukemia Working Party of the EBMT.

Bug, Gesine; Labopin, Myriam; Niittyvuopio, Riitta; Stelljes, Matthias; Reinhardt, Hans Christian; Hilgendorf, Inken; Kröger, Nicolaus; Kaare, Ain; Bethge, Wolfgang; Schäfer-Eckart, Kerstin; Verbeek, Mareike; Mielke, Stephan; Carlson, Kristina; Bazarbachi, Ali; Spyridonidis, Alexandros; Savani, Bipin N; Nagler, Arnon; Mohty, Mohamad

doi:10.1038/s41409-023-01965-x

Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie (Prof. Bassermann)

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Title:: Fludarabine/TBI 8 Gy versus fludarabine/treosulfan conditioning in patients with AML in first complete remission: a study from the Acute Leukemia Working Party of the EBMT.
Document type:: Article; Journal Article; Research Support, Non-U.S. Gov't
Author(s):: Bug, Gesine; Labopin, Myriam; Niittyvuopio, Riitta; Stelljes, Matthias; Reinhardt, Hans Christian; Hilgendorf, Inken; Kröger, Nicolaus; Kaare, Ain; Bethge, Wolfgang; Schäfer-Eckart, Kerstin; Verbeek, Mareike; Mielke, Stephan; Carlson, Kristina; Bazarbachi, Ali; Spyridonidis, Alexandros; Savani, Bipin N; Nagler, Arnon; Mohty, Mohamad
Abstract:: The optimal reduced intensity conditioning (RIC) regimen is a matter of debate. We retrospectively compared conditioning with fludarabine plus fractionated total body irradiation of 8 Gy (FluTBI) and fludarabine plus treosulfan 30, 36 or 42 g/m2 (FluTreo) in 754 patients with AML above the age of 40 years undergoing an allogeneic hematopoietic stem cell transplant (HSCT) in first complete remission (CR). After balancing patient characteristics by propensity score matching of 115 patients in each group, FluTBI was associated with a significantly lower probability of relapse compared to FluTreo (18.3% vs. 34.7%, p = 0.018) which was counteracted by a higher non-relapse mortality (NRM, 16.8% vs. 5.3%, p = 0.02). Thus, overall survival and graft-versus-host disease-free and relapse-free survival at 2 years were similar between groups (OS 66.9% vs. 67.8%, GRFS 50.3% vs. 45.6%). Univariate analysis by age group demonstrated a higher NRM exclusively in patients ≥55 years of age treated with FluTBI compared to FluTreo (27.6% vs. 5.8%, p = 0.02), while a similarly low NRM was observed in patients <55 years in both groups (6.0% vs. 4.7%, p = ns). We conclude that both conditioning regimens are effective and safe, but FluTBI may better be reserved for younger patients below the age of 55 years.
Journal title abbreviation:: Bone Marrow Transplant
Year:: 2023
Journal volume:: 58
Journal issue:: 6
Pages contribution:: 710-716
Fulltext / DOI:: doi:10.1038/s41409-023-01965-x
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/37002412
Print-ISSN:: 0268-3369
TUM Institution:: 154; Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie (Prof. Bassermann)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie (Prof. Bassermann)2023