AI Article Synopsis

  • A registry analysis was conducted on adult acute myeloid leukemia (AML) patients in remission who underwent haplo-hematopoietic stem cell transplant (HSCT) between 2010 and 2020, comparing thiotepa, busulfan, and fludarabine (TBF) versus treosulfan (Treo) conditioning.
  • The study included 1123 patients, with 968 receiving TBF and 155 receiving Treo, and a matched-pair analysis was performed on 142 patients from each group to assess outcomes.
  • No significant differences were found in terms of graft-versus-host disease incidence, nonrelapse mortality, or leukemia-free survival between the two conditioning

Article Abstract

We conducted a registry analysis including adult acute myeloid leukemia (AML) patients in remission who had received thiotepa, busulfan, and fludarabine (TBF) or treosulfan-based (Treo) conditioning for haplo-hematopoietic stem cell transplant (HSCT) with posttransplant cyclophosphamide (PTCy) between 2010 and 2020. A total of 1123 patients met the inclusion criteria (968 received TBF and 155 received Treo). A 1:1 matched-pair analysis was performed on 142 TBF and 142 Treo patients. In the Treo group, 68% of patients received treosulfan at a dose ≥36 g/m and 54% of patients received a second alkylator (thiotepa or melphalan). We observed a trend toward increased incidence of grade II-IV acute (a) graft-versus-host disease (GVHD) at 180 days in the TBF group compared with Treo (29% versus 20%; = 0.08), while incidence of grade III-IV aGVHD was not statistically different. Similarly, the incidence of chronic (c) GVHD was not statistically different in the 2 groups. Incidence of nonrelapse mortality at 2 years was 19% in TBF and 14% in Treo ( = 0.4). Relapse incidence at 2 years was not statistically different in the 2 groups (16% and 18% in TBF and Treo, respectively; = 0.9). Leukemia-free survival, overall survival, and GVHD-free, relapse-free survival was 65% versus 68% ( = 0.6), 73% versus 76% ( = 0.5), and 54% versus 53% ( = 0.8) in TBF versus Treo, respectively. In conclusion, we did not find a significant difference between the 2 conditioning in the present study; Treo and TBF represent 2 valid alternative regimens for haplo-HSCT with PTCy for AML in remission.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513143PMC
http://dx.doi.org/10.1097/HS9.0000000000000952DOI Listing

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