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Fludarabine/busulfan versus fludarabine/total-body-irradiation (2 Gy) as conditioning prior to allogeneic stem cell transplantation in patients (≥60 years) with acute myelogenous leukemia: a study of the acute leukemia working party of the EBMT

Heinicke, T., Labopin, M., Polge, E., Niederwieser, D., Platzbecker, U., Sengelov, H., Choi, G., Cornelissen, J., Blaise, D., Kuball, J., van Gorkom, G., Schaap, N., Potter, V., Paul, F., Savani, B. N., Nagler, A. & Mohty, M., 23-Oct-2019, In : Bone marrow transplantation. 11 p.

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  • Fludarabine/busulfan versus fludarabine/total-body-irradiation (2 Gy) as conditioning prior to allogeneic stem cell transplantation in patients (≥60 years) with acute myelogenous leukemia

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DOI

  • Thomas Heinicke
  • Myriam Labopin
  • Emmanuelle Polge
  • Dietger Niederwieser
  • Uwe Platzbecker
  • Henrik Sengelov
  • Goda Choi
  • Jan Cornelissen
  • Didier Blaise
  • Jürgen Kuball
  • Gwendolyn van Gorkom
  • Nicolaas Schaap
  • Victoria Potter
  • Franciane Paul
  • Bipin N Savani
  • Arnon Nagler
  • Mohamad Mohty

Nonmyeloablative (NMA) conditioning regimens facilitate allogeneic stem cell transplantation (alloSCT) in elderly patients and/or in those with comorbidities. The acute leukemia working party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) compared the outcomes of patients ≥60 years with AML in first complete remission (CR1), that had received an alloSCT following NMA conditioning, i.e. either fludarabine/busulfan (FB2) or fludarabine/total-body-irradiation-2Gy (FluTBI2Gy). A total of 1088 patients were included (median age 65 years). Donors were matched siblings (MSD) and matched unrelated donors (MUD) in 47% and 53%, respectively. In vivo T-cell depletion (TCD) was applied to 79% and none (0%) of patients in the FB2 and FluTBI2Gy groups, respectively. In the MSD group we found a trend for less extensive cGVHD in patients receiving FB2 with in vivo TCD, HR: 0.49, p = 0.08, and in those without worse NRM, HR: 2.14, p = 0.04, and a trend for more total cGVHD, HR: 1.61, p = 0.09. Patients transplanted from MUDs had a significantly higher incidence of total cGVHD, extensive cGVHD and a worse GRFS with FluTBI2Gy in comparison to FB2, HR: 2.44; p < 0.0001; HR 4.59; p < 0.00001 and HR: 1.35; p = 0.03, respectively. No differences were observed with respect to LFS, OS, RI, NRM, and aGVHD.

Original languageEnglish
Number of pages11
JournalBone marrow transplantation
Publication statusE-pub ahead of print - 23-Oct-2019

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