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Double alkylators based conditioning reduced the relapse rate after allogeneic peripheral blood stem cell transplantation in adult patients with myeloid malignancies: a single arm phase II study

Bone Marrow Transplantation volume 57, pages 843–845 (2022)Cite this article

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To the Editor,

Fludarabine (Flu) in combination with busulfan (Bu) was the mainstay of conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia (AML) and myelodysplasia syndrome (MDS) [1,2,3]. Relapse remained as a major cause of treatment failure. An EBMT registry study demonstrated that conditioning with Bu and melphalan (Mel) was associated with lower relapse rate, higher leukemia free survival and comparable non-relapse mortality (NRM) in AML patients undergoing autologous HSCT [4]. In allo-HSCT setting, Mel (80–100 mg/m2) added to Flu-Bu4 conditioning showed significant low relapse rate in patients with AML and MDS [5, 6]. Of note, adding Mel to standard four-day Bu lead to increased NRM. Here, we presented the results of a Phase II clinical study, which evaluated a new conditioning regimen with Flu, two-day Bu and Mel (100 or 140 mg/m2) in patients with myeloid malignancies (NCT 04269811).

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Fig. 1: Outcomes after transplantation.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author notes

  1. These authors contributed equally: Jie-ling Jiang, Ming Chen, Li-ning Wang, Ling Wang, Jiong Hu.

Authors and Affiliations

  1. Shanghai Institute of Hematology, Blood & Marrow Transplantation Center, Collaborative Innovation Center of Hematology, Department of Hematology, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Jie-ling Jiang, Ming Chen, Li-ning Wang, Wen-hui Gao, Ling Wang & Jiong Hu

  2. Shanghai Clinical Research Center (SCRC), Feng Lin International Centre, Shanghai, China

    Min Wan

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  1. Jie-ling Jiang
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Contributions

JH and LW was responsible for designing the clinical trial and revising the manuscript. JjL, MC and LnW collected the clinical data and wrote the report. WhG contributed to data extraction and provided feedback on the report. Ming Wan did the statistical analysis.

Corresponding authors

Correspondence to Ling Wang or Jiong Hu.

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Jiang, Jl., Chen, M., Wang, Ln. et al. Double alkylators based conditioning reduced the relapse rate after allogeneic peripheral blood stem cell transplantation in adult patients with myeloid malignancies: a single arm phase II study. Bone Marrow Transplant 57, 843–845 (2022). https://doi.org/10.1038/s41409-022-01643-4

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  • DOI: https://doi.org/10.1038/s41409-022-01643-4

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