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Phase II study of myeloablative allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia in adults using fludarabine and total body irradiation 12 Gy

Bone Marrow Transplantation volume 57, pages 1597–1599 (2022)Cite this article

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Post-remission therapy for adults with acute lymphoblastic leukemia (ALL) has traditionally involved allogeneic hematopoietic stem cell transplantation (allo-hsct), for high-risk features such as Philadelphia chromosome-positive (Ph+) disease, older age, particular cytogenetic abnormalities, and measurable residual disease (MRD) positivity post-induction [1].

Total body irradiation (TBI) based myeloablative conditioning (MAC) is the preferred regimen in eligible patients. TBI, combined with cyclophosphamide (Cy), is commonly used in ALL [2]. However, Cy may cause severe toxicities in older or unfit patients. Multiple studies have now substituted Cy with Fludarabine (Flu), in Busulfan (Bu) based regimens, and noted a similar efficacy along with favorable toxicity profile with Flu [3, 4]. However, the effectiveness of a MAC regimen of Flu-TBI in adult patients with ALL remains unclear.

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Fig. 1: Survival Outcomes.

Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Omer Jamy, Donna Salzman & Antonio Di Stasi

  2. Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Sankalp Arora

  3. Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA

    Ruby Meredith

  4. Division of Hematology and Oncology, Department of Medicine, Pennsylvania State University, University Park, PA, USA

    Kentaro Minagawa & Shin Mineishi

  5. Division of Hematology and Oncology, Department of Medicine, Ohio State University, Columbus, OH, USA

    Ayman Saad

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  1. Omer Jamy
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Contributions

OJ, AS and SM contributed to the conception of the presented study. OJ and SA contributed to data collection and analysis. OJ, SA, ADS, RM, DS, KM, SM and AS contributed to drafting, revising, and approving the manuscript.

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Correspondence to Omer Jamy.

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Jamy, O., Arora, S., Meredith, R. et al. Phase II study of myeloablative allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia in adults using fludarabine and total body irradiation 12 Gy. Bone Marrow Transplant 57, 1597–1599 (2022). https://doi.org/10.1038/s41409-022-01757-9

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