Fiche publication
Date publication
juin 2025
Journal
Bone marrow transplantation
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DECONINCK Eric
Tous les auteurs :
Dachy G, Labopin M, Socié G, Castilla-Llorente C, Forcade E, Blau IW, Ceballos P, Deconinck E, Burns D, Bulabois CE, Vrhovac R, Huynh A, Blaise D, Maertens J, Schroeder T, Bay JO, Savani B, Spyridonidis A, Ciceri F, Mohty M
Lien Pubmed
Résumé
In the past decades, treatment for acute myeloid leukemia (AML) has advanced, but allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains vital for improving survival in most patients. This retrospective study, conducted on behalf of the Acute Leukemia Working Party of the EBMT, examines the impact of fludarabine dose in reduced-intensity conditioning regimens on clinical outcomes in patients over 50 years old with AML in first complete remission, without chronic kidney disease. We analyzed 1907 patients who underwent allo-HSCT between 2010 and 2022, stratifying them into four fludarabine dose groups: 110-130 mg/m, 140-150 mg/m, 151-160 mg/m, and 170-190 mg/m. Our results suggest that a lower fludarabine dose (≤130 mg/m) is associated with significantly improved leukemia-free survival (LFS), graft-versus-host disease-free/relapse-free survival (GRFS), overall survival, and reduced non-relapse mortality. Multivariate analysis shows that a lower fludarabine dose (≤130 mg/m) was associated with significantly improved LFS (HR 1.46, 95% CI: 1.09-1.94) and GRFS (HR 1.50, 95% CI: 1.12-1.99). These findings indicate that using a lower fludarabine dosing in older AML patients may improve the efficacy and tolerability of allo-HSCT. Further studies are needed to validate these observations to confirm and expand upon our results, particularly in diverse patient populations and other indications for allo-HSCT.
Référence
Bone Marrow Transplant. 2025 06 19;:
