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Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: An analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP)

Bone Marrow Transplantation volume 57, pages 1803–1809 (2022)Cite this article

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Abstract

Different doses of treosulfan plus fludarabine have shown advantage over reduced intensity regimens. However, data comparing higher doses of treosulfan to myeloablative busulfan are limited. Thus, we compared outcomes between FT14 (fludarabine 150/160 mg/m2 and treosulfan 42 g/m2, or FT14) over FB4 (fludarabine 150/160 mg/m2 and busulfan 12.8 mg/kg). We retrospectively studied patients from European Society for Blood and Marrow Transplantation registry: a) adults diagnosed with acute myeloid leukemia (AML), b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated or sibling donor (2010–2020), c) HSCT at first or second complete remission, d) conditioning with FT14 or FB4. FT14 recipients (n = 678) were older, with higher rates of secondary AML, unrelated donors, peripheral blood grafts, and adverse cytogenetics, but lower percentage of female donor to male recipient compared to FB4 (n = 2025). Analysis was stratified on age. In patients aged < 55 years, FT14 was associated with higher relapse incidence (RI) and lower Leukemia-Free Survival (LFS). In patients aged≥55 years, acute GVHD CI was higher in FB4, without significant differences in other outcomes. Although FT14 has been used for higher-risk HSCT patients, our large real-world multicenter study suggests that FB4 is associated with better outcomes compared to FT14 in younger patients.

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Fig. 1: Outcomes in patients younger than 55 years.
Fig. 2: Outcomes in patients 55 years or older.

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Data are available upon request from the corresponding author.

References

  1. Thein MS, Ershler WB, Jemal A, Yates JW, Baer MR. Outcome of older patients with acute myeloid leukemia: an analysis of SEER data over 3 decades. Cancer. 2013;119:2720–7. https://doi.org/10.1002/cncr.28129.

    Article  PubMed  Google Scholar 

  2. Alam N, Atenafu EG, Kuruvilla J, Uhm J, Lipton JH, Messner HA, et al. Outcomes of patients with therapy-related AML/myelodysplastic syndrome (t-AML/MDS) following hematopoietic cell transplantation. Bone marrow Transplant. 2015;50:1180–6. https://doi.org/10.1038/bmt.2015.151.

    Article  CAS  PubMed  Google Scholar 

  3. Kayser S, Dohner K, Krauter J, Kohne CH, Horst HA, Held G, et al. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood 2011;117:2137–45. https://doi.org/10.1182/blood-2010-08-301713.

    Article  CAS  PubMed  Google Scholar 

  4. Jethava YS, Sica S, Savani B, Socola F, Jagasia M, Mohty M, et al. Conditioning regimens for allogeneic hematopoietic stem cell transplants in acute myeloid leukemia. Bone marrow Transplant. 2017;52:1504–11. https://doi.org/10.1038/bmt.2017.83.

    Article  CAS  PubMed  Google Scholar 

  5. Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2009;15:1628–33. https://doi.org/10.1016/j.bbmt.2009.07.004.

    Article  Google Scholar 

  6. Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G, et al. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998;91:756–63.

    Article  CAS  PubMed  Google Scholar 

  7. de Lima M, Anagnostopoulos A, Munsell M, Shahjahan M, Ueno N, Ippoliti C, et al. Nonablative versus reduced-intensity conditioning regimens in the treatment of acute myeloid leukemia and high-risk myelodysplastic syndrome: dose is relevant for long-term disease control after allogeneic hematopoietic stem cell transplantation. Blood. 2004;104:865–72. https://doi.org/10.1182/blood-2003-11-3750.

    Article  CAS  PubMed  Google Scholar 

  8. Shimoni A, Hardan I, Shem-Tov N, Yeshurun M, Yerushalmi R, Avigdor A, et al. Allogeneic hematopoietic stem-cell transplantation in AML and MDS using myeloablative versus reduced-intensity conditioning: the role of dose intensity. Leukemia. 2006;20:322–8. https://doi.org/10.1038/sj.leu.2404037.

    Article  CAS  PubMed  Google Scholar 

  9. Oliansky DM, Appelbaum F, Cassileth PA, Keating A, Kerr J, Nieto Y, et al. The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of acute myelogenous leukemia in adults: an evidence-based review. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2008;14:137–80. https://doi.org/10.1016/j.bbmt.2007.11.002.

    Article  Google Scholar 

  10. Nagler A, Labopin M, Shimoni A, Niederwieser D, Mufti GJ, Zander AR, et al. Mobilized peripheral blood stem cells compared with bone marrow as the stem cell source for unrelated donor allogeneic transplantation with reduced-intensity conditioning in patients with acute myeloid leukemia in complete remission: an analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2012;18:1422–9. https://doi.org/10.1016/j.bbmt.2012.02.013.

    Article  Google Scholar 

  11. Danylesko I, Shimoni A, Nagler A. Treosulfan-based conditioning before hematopoietic SCT: More than a BU look-alike. Bone marrow Transplant. 2012;47:5–14. https://doi.org/10.1038/bmt.2011.88.

    Article  CAS  PubMed  Google Scholar 

  12. Slatter MA, Boztug H, Potschger U, Sykora KW, Lankester A, Yaniv I, et al. Treosulfan-based conditioning regimens for allogeneic haematopoietic stem cell transplantation in children with non-malignant diseases. Bone marrow Transplant. 2015;50:1536–41. https://doi.org/10.1038/bmt.2015.171.

    Article  CAS  PubMed  Google Scholar 

  13. Strocchio L, Zecca M, Comoli P, Mina T, Giorgiani G, Giraldi E, et al. Treosulfan-based conditioning regimen for -logeneic haematopoietic stem cell transplantation in children with sickle cell disease. Br urinal Haematol. 2015;169:726–36. https://doi.org/10.1111/bjh.13352.

    Article  CAS  Google Scholar 

  14. Boztug H, Sykora KW, Slatter M, Zecca M, Veys P, Lankester A, et al. European Society for Blood and Marrow Transplantation Analysis of Treosulfan Conditioning Before Hematopoietic Stem Cell Transplantation in Children and Adolescents With Hematological Malignancies. Pediatr Blood Cancer. 2016;63:139–48. https://doi.org/10.1002/pbc.25764.

    Article  CAS  PubMed  Google Scholar 

  15. Ruutu T, Volin L, Beelen DW, Trenschel R, Finke J, Schnitzler M, et al. Reduced-toxicity conditioning with treosulfan and fludarabine in allogeneic hematopoietic stem cell transplantation for myelodysplastic syndromes: final results of an international prospective phase II trial. Haematologica. 2011;96:1344–1350. https://doi.org/10.3324/haematol.2011.043810.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sjoo F, Hassan Z, Abedi-Valugerdi M, Griskevicius L, Nilsson C, Remberger M, et al. Myeloablative and immunosuppressive properties of treosulfan in mice. Exp Hematol. 2006;34:115–21. https://doi.org/10.1016/j.exphem.2005.09.015.

    Article  CAS  PubMed  Google Scholar 

  17. Glowka F, Kasprzyk A, Romanski M, Wrobel T, Wachowiak J, Szpecht D, et al. Pharmacokinetics of treosulfan and its active monoepoxide in pediatric patients after intravenous infusion of high-dose treosulfan prior to HSCT. Eur J Pharm Sci: Off J Eur Federation Pharm Sci. 2015;68:87–93. https://doi.org/10.1016/j.ejps.2014.12.010.

    Article  CAS  Google Scholar 

  18. Kroger N, Shimoni A, Zabelina T, Schieder H, Panse J, Ayuk F. et al.Reduced-toxicity conditioning with treosulfan, fludarabine and ATG as preparative regimen for allogeneic stem cell transplantation (alloSCT) in elderly patients with secondary acute myeloid leukemia (sAML) or myelodysplastic syndrome (MDS).Bone Marrow Transpl.2006;37:339–44. https://doi.org/10.1038/sj.bmt.1705259.

    Article  CAS  Google Scholar 

  19. Shimoni A, Hardan I, Shem-Tov N, Rand A, Yerushalmi R, Nagler A. Fludarabine and treosulfan: a novel modified myeloablative regimen for allogeneic hematopoietic stem-cell transplantation with effective antileukemia activity in patients with acute myeloid leukemia and myelodysplastic syndromes. Leuk Lymphoma. 2007;48:2352–9. https://doi.org/10.1080/10428190701671051.

    Article  CAS  PubMed  Google Scholar 

  20. Nemecek ER, Guthrie KA, Sorror ML, Wood BL, Doney KC, Hilger RA, et al. Conditioning with treosulfan and fludarabine followed by allogeneic hematopoietic cell transplantation for high-risk hematologic malignancies. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2011;17:341–50. https://doi.org/10.1016/j.bbmt.2010.05.007.

    Article  CAS  Google Scholar 

  21. Casper J, Holowiecki J, Trenschel R, Wandt H, Schaefer-Eckart K, Ruutu T, et al. Allogeneic hematopoietic SCT in patients with AML following treosulfan/fludarabine conditioning. Bone marrow Transplant. 2012;47:1171–7. https://doi.org/10.1038/bmt.2011.242.

    Article  CAS  PubMed  Google Scholar 

  22. Gyurkocza B, Gutman J, Nemecek ER, Bar M, Milano F, Ramakrishnan A, et al. Treosulfan, fludarabine, and 2-Gy total body irradiation followed by allogeneic hematopoietic cell transplantation in patients with myelodysplastic syndrome and acute myeloid leukemia. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2014;20:549–55. https://doi.org/10.1016/j.bbmt.2014.01.009.

    Article  CAS  Google Scholar 

  23. Casper J, Wolff D, Knauf W, Blau IW, Ruutu T, Volin L, et al. Allogeneic hematopoietic stem-cell transplantation in patients with hematologic malignancies after dose-escalated treosulfan/fludarabine conditioning. J Clin Oncol: Off J Am Soc Clin Oncol. 2010;28:3344–51. https://doi.org/10.1200/JCO.2009.23.3429.

    Article  CAS  Google Scholar 

  24. Zhu S, Liu G, Liu J, Chen Q, Wang Z. Long-Term Outcomes of Treosulfan- vs. Busulfan-Based Conditioning Regimen for Patients With Myelodysplastic Syndrome and Acute Myeloid Leukemia Before Hematopoietic Cell Transplantation: A Systematic Review and Meta-Analysis. Front Oncol. 2020;10:591363 https://doi.org/10.3389/fonc.2020.591363.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Beelen DW, Trenschel R, Stelljes M, Groth C, Masszi T, Remenyi, et al. Treosulfan or busulfan plus fludarabine as conditioning treatment before allogeneic haemopoietic stem cell transplantation for older patients with acute myeloid leukaemia or myelodysplastic syndrome (MC-FludT.14/L): A randomised, non-inferiority, phase 3 trial. Lancet Haematol. 2020;7:e28–e39. https://doi.org/10.1016/S2352-3026(19)30157-7.

    Article  PubMed  Google Scholar 

  26. Sakellari I, Mallouri D, Gavriilaki E, Batsis I, Kaliou M, Constantinou V, et al. Survival Advantage and Comparable Toxicity in Reduced-Toxicity Treosulfan-Based versus Reduced-Intensity Busulfan-Based Conditioning Regimen in Myelodysplastic Syndrome and Acute Myeloid Leukemia Patients after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2017;23:445–51. https://doi.org/10.1016/j.bbmt.2016.11.023.

    Article  CAS  Google Scholar 

  27. Shimoni A, Shem-Tov N, Volchek Y, Danylesko I, Yerushalmi R, Nagler A. Allo-SCT for AML and MDS with treosulfan compared with BU-based regimens: reduced toxicity vs reduced intensity. Bone marrow Transplant. 2012;47:1274–82. https://doi.org/10.1038/bmt.2012.4.

    Article  CAS  PubMed  Google Scholar 

  28. Gooley TA, Leisenring W, Crowley J, Storer BE. Estimation of failure probabilities in the presence of competing risks: New representations of old estimators. Stat Med. 1999;18:695–706.

    Article  CAS  PubMed  Google Scholar 

  29. Sakellari I, Gavriilaki E, Mallouri D, Batsis I, Varelas C, Tagara S, et al. Survival Advantage of Treosulfan Plus Fludarabine Before Allogeneic Hematopoietic Cell Transplantation for Older or Comorbid Patients With Myeloid Malignancies. Transpl Cell Ther. 2021;27:916 e911–916. https://doi.org/10.1016/j.jtct.2021.07.020.

    Article  CAS  Google Scholar 

  30. Passweg JR, Baldomero H, Basak GW, Chabannon C, Corbacioglu S, Duarte R, et al. The EBMT activity survey report 2017: A focus on allogeneic HCT for nonmalignant indications and on the use of non-HCT cell therapies. Bone Marrow Transplant. 2019;54:1575–85. https://doi.org/10.1038/s41409-019-0465-9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Loke J, Malladi R, Moss P, Craddock C. The role of allogeneic stem cell transplantation in the management of acute myeloid leukaemia: A triumph of hope and experience. Br J Haematol. 2020;188:129–46. https://doi.org/10.1111/bjh.16355.

    Article  PubMed  Google Scholar 

  32. Fasslrinner F, Schetelig J, Burchert A, Kramer M, Trenschel R, Hegenbart U, et al. Long-term efficacy of reduced-intensity versus myeloablative conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: Retrospective follow-up of an open-label, randomised phase 3 trial. Lancet Haematol. 2018;5:e161–e169. https://doi.org/10.1016/S2352-3026(18)30022-X.

    Article  PubMed  Google Scholar 

  33. Scott BL, Pasquini MC, Logan BR, Wu J, Devine SM, Porter DL, et al. Myeloablative Versus Reduced-Intensity Hematopoietic Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndromes. J Clin Oncol: Off J Am Soc Clin Oncol. 2017;35:1154–61. https://doi.org/10.1200/JCO.2016.70.7091.

    Article  Google Scholar 

  34. Rambaldi A, Grassi A, Masciulli A, Boschini C, Mico MC, Busca A, et al. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: An open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015;16:1525–36. https://doi.org/10.1016/S1470-2045(15)00200-4.

    Article  CAS  PubMed  Google Scholar 

  35. Spyridonidis A, Labopin M, Savani BN, Niittyvuopio R, Blaise D, Craddock C, et al. Redefining and measuring transplant conditioning intensity in current era: A study in acute myeloid leukemia patients. Bone Marrow Transplant. 2020;55:1114–25. https://doi.org/10.1038/s41409-020-0803-y.

    Article  CAS  PubMed  Google Scholar 

  36. Wedge E, Sengelov H, Hansen JW, Andersen NS, Schjodt I, Petersen SL, et al. Improved Outcomes after Allogenic Hematopoietic Stem Cell Transplantation with Fludarabine/Treosulfan for Patients with Myelodysplastic Syndromes. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2020;26:1091–8. https://doi.org/10.1016/j.bbmt.2020.02.010.

    Article  CAS  Google Scholar 

  37. Fein JA, Shimoni A, Labopin M, Shem-Tov N, Yerushalmi R, Magen H, et al. The impact of individual comorbidities on non-relapse mortality following allogeneic hematopoietic stem cell transplantation. Leukemia 2018;32:1787–94. https://doi.org/10.1038/s41375-018-0185-y.

    Article  PubMed  Google Scholar 

  38. Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: A new tool for risk assessment before allogeneic HCT. Blood 2005;106:2912–9. https://doi.org/10.1182/blood-2005-05-2004.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Cheung E, Perissinotti AJ, Bixby DL, Burke PW, Pettit KM, Benitez LL, et al. The leukemia strikes back: A review of pathogenesis and treatment of secondary AML. Ann Hematol. 2019;98:541–59. https://doi.org/10.1007/s00277-019-03606-0.

    Article  PubMed  Google Scholar 

  40. Sengsayadeth S, Labopin M, Boumendil A, Finke J, Ganser A, Stelljes M, et al. Transplant Outcomes for Secondary Acute Myeloid Leukemia: Acute Leukemia Working Party of the European Society for Blood and Bone Marrow Transplantation Study. Biol Blood Marrow Transplant: J Am Soc Blood Marrow Transplant. 2018;24:1406–14. https://doi.org/10.1016/j.bbmt.2018.04.008.

    Article  Google Scholar 

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Acknowledgements

EG is supported by the ASH Global Research Award.

Author information

Authors and Affiliations

  1. Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece

    Eleni Gavriilaki, Ioanna Sakellari & Achilles Anagnostopoulos

  2. Service d’ Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France

    Myriam Labopin & Mohamad Mohty

  3. HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit – Helsinki, Helsinki, Finland

    Urpu Salmenniemi

  4. CHU de Lille, univ Lille, INSERM U1286, Infinite, 59000, Lille, France

    Ibrahim Yakoub-Agha

  5. Kings College Hospital, Dept. of Haematological Medicine, King’s Denmark Hill Campus – London, London, UK

    Victoria Potter

  6. Hopital Jean Minjoz, Service d’Hématologie – Besançon, Besançon, France

    Ana Berceanu

  7. Department of Oncology and Hematology, University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy

    Alessandro Rambaldi

  8. Universitaetsklinikum Jena, Klinik für Innere Medizin II – Jena, Jena, Germany

    Inken Hilgendorf

  9. University Hospital Eppendorf, Bone Marrow Transplantation Centre – Hamburg, Hamburg, Germany

    Nicolaus Kröger

  10. Karolinska University Hospital, Dept. of Hematology – Stockholm, Stockholm, Sweden

    Stephan Mielke

  11. Rambam Medical Center, Dept. of Hematology & BMT – Haifa, Haifa, Israel

    Tsila Zuckerman

  12. University Hospital La Fe, Hematology Department – Valencia, Valencia, Spain

    Jaime Sanz

  13. S.S.C.V.D Trapianto di Cellule Staminali, A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy

    Alessandro Busca

  14. Baskent University Hospital, Haematology Division, BMT Unit, Haematology Reserach Laboratory, Training & Medical – Adana, Adana, Turkey

    Hakan Ozdogu

  15. Vanderbilt University Medical Center, Division of Hematology/ Oncology, Nashville, TN, USA

    Bipin Savani

  16. Maria Sklodowska-Curie Institute, Department of Bone Marrow Transplantation and Oncohematology, Oncology Center – Gliwice, Gliwice, Poland

    Sebastian Giebel

  17. American University of Beirut, Medical Center, Department of Internal Medicine – Beirut, Beirut, Lebanon

    Ali Bazarbachi

  18. Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece

    Alexandros Spyridonidis

  19. Chaim Sheba Medical Center, Dept. of Bone Marrow Transplantation - Tel-Hashomer, Tel-Hashomer, Israel

    Arnon Nagler

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  1. Eleni Gavriilaki
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Contributions

EG and IS designed research and wrote the original draft, provided clinical data; ML participated in research design, performed statistical analysis, and drafted the Tables and Figures; US, IYA, VP, AB, AR, IH, NK, SM, TZ, JS, AB, HO provided clinical data and edited the manuscript; AA, BS, SG, AB, AS, AN, and MM participated in research design and edited the manuscript. All authors approved the final manuscript.

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Correspondence to Eleni Gavriilaki.

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Gavriilaki, E., Labopin, M., Sakellari, I. et al. Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: An analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP). Bone Marrow Transplant 57, 1803–1809 (2022). https://doi.org/10.1038/s41409-022-01830-3

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