Comparison of fludarabine/melphalan (FM140) with fludarabine/melphalan/BCNU (FBM110) in patients with relapsed/refractory AML undergoing allogeneic hematopoietic cell transplantation – a registry study on behalf of the EBMT Acute Leukemia Working Party
Year: 2024
Type: article
Study design: Observational Study
Abstract: The treatment of relapsed/refractory acute myeloid leukemia (AML) is associated with a dismal prognosis. The allogeneic hematopoietic cell transplantation (allo-HCT) is frequently performed as salvage therapy. Reduced intensity conditioning protocols have been developed with the aim of reducing the leukemia burden without increasing their toxicity. We compared the reduced intensity conditioning FM140 (fludarabine, 150 mg/m2; melphalan 140 mg/m2) with FBM110 (fludarabine 150 mg/m2; BCNU, also known as carmustine, 300–400 mg/m2; and melphalan 110 mg/m2). From the European Bone Marrow Transplantation (EBMT) Acute Leukemia Working Party registry, we identified 293 adult patients (FM140, n = 118 and FBM110, n = 175) with AML with relapsed/refractory disease prior to allo-HCT. There were some differences such as age (FM140 = 59.5 years vs. FBM110 = 65.1 years, p < 0.001) and graft-versus-host disease (GvHD) prophylaxis based on in vivo T-cell depletion (TCD, FM140 = 39% vs. FBM110 = 75%, p < 0.001). No differences were observed between FM140- and FBM110-treated patients regarding overall survival (OS) (2-year OS: 39.3% vs. 45.7%, p = 0.58), progression-free survival (PFS) (2-year PFS: 36.1% vs. 37.3%, p = 0.69), non-relapse mortality (NRM) (2-year NRM: 15.3% vs. 25.7%, p = 0.10) and relapse incidence (RI) (2-year RI: 48.6% vs. 37.0%, p = 0.7). In conclusion, despite differences in age and GvHD prophylaxis, AML patients with active disease undergoing allo-HCT after FBM110 conditioning showed similar outcomes compared to FM140.
Source: Bone Marrow Transplantation
Authors: Jesús Duque-Afonso, Jürgen Finke, Maud Ngoya, Jacques-Emmanuel Galimard, Johannes Schetelig, Matthias Eder, Wolf Rösler, Gesine Bug, Andreas Neubauer, Matthias Edinger, Gerald. G. Wulf, Pavel Jindra, Hermann Einsele, Matthias Stelljes, Dominik Selleslag, Eva Maria Wagner-Drouet, Donald Bunjes, Alexandros Spyridonidis, Eolia Brissot, Arnon Nagler, Fabio Ciceri, Mohamad Mohty
Institutions: University of Freiburg, University Medical Center Freiburg, Inserm, Hôpital Saint-Antoine, Centre de Recherche Saint-Antoine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Medizinische Hochschule Hannover, Universitätsklinikum Erlangen, Goethe University Frankfurt, Philipps University of Marburg, Universitätsklinikum Gießen und Marburg, University of Regensburg, Universitätsmedizin Göttingen, University of Göttingen, Charles University, Universitätsklinikum Würzburg, University of Münster, AZ Sint-Jan, University Medical Center of the Johannes Gutenberg University Mainz, University Hospital Ulm, University of Patras, General University Hospital of Patras, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Sheba Medical Center, Vita-Salute San Raffaele University
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,690
OpenAlex ID: W4405606724