Evaluation of six different types of sequential conditioning regimens for allogeneic stem cell transplantation in relapsed/refractory acute myelogenous leukemia – a study of the Acute Leukemia Working Party of the EBMT

Abstract

The Acute Leukemia Working Party (ALWP) of the EBMT assessed the outcome of allogeneic stem cell transplantation (alloSCT) in patients with relapsed/refractory AML (r/rAML) evaluating six sequential conditioning regimens (SR) groups. A total of 2132 patients were included. LFS at 2 years was 28.9%, 33.6%, 35.3%, 20.6%, 24.4%, and 27% for the FLAMSA-TBI4, FLAMSA-Chemo, Mel-Flu-TBI8, Mel-Treo-Flu, Thio-ETO-Cy-Bu2-Flu, and Clo-ARAC-(Bu2/TBI4)-Cy groups, respectively. In patients <55 years of age Mel-Flu-TBI8 had the best LFS, which was statistically significant only in comparison to the Mel-Treo-Flu group, while in patients ≥55 years LFS was best with FLAMSA-Chemo without significant differences compared to FLAMSA-TBI4 and Mel-Flu-TBI8. Furthermore, best NRM rates were obtained with the two FLAMSA regimens groups. Our study suggests that in younger (<55 years) patients a more intense regimen might be used whereas in older (≥55 years) patients the focus might be more on tolerability.

Keywords:

• Relapsed/refractory AML
• sequential conditioning regimens
• clinical results

Disclosure statement

Dr. Heinicke reports grants from Jazz Pharmaceuticals, grants from Gilead, grants from Eurocept, grants from Daichii, outside the submitted work. Dr Bethge reports grants, personal fees for consultancy and payment for lectures including service on speakers bureaus from Milteny Biotech and payment for lectures including service on speakers bureaus from Novartis and Gilead outside the submitted work. Dr. Wagner reports board membership with Novartis, MSD and Kite/Gilead as well as travel grants from Medac and MSD outside the submitted work. Dr. Platzbecker reports personal fees for consultancy from Novartis, AbbVie, Janssen, Celgene, Takeda and Geron outside the submitted work. Dr. Mohty reports personal fees from Amgen, personal fees from Celgene, grants, personal fees and non-financial support from Janssen, grants, personal fees and non-financial support from Sanofi, personal fees and non-financial support from Takeda, personal fees from Astellas, personal fees from Pfizer, personal fees from Adaptive Biotechnologies, grants, personal fees and non-financial support from Jazz, personal fees from GlaxosmithKline, grants and personal fees from Novartis, outside the submitted work. All other authors have nothing to disclose.