{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T01:32:47Z","timestamp":1768267967944,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,5,30]],"date-time":"2013-05-30T00:00:00Z","timestamp":1369872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:p>The role of reduced\u2010intensity conditioning (RIC) in adult acute lymphoblastic leukemia (ALL) remains unclear because of the small sample size, short follow\u2010up duration, various regimens for conditioning and graft\u2010versus\u2010host disease (GVHD) prophylaxis, and the heterogeneity of selection criteria for transplantation. We compared long\u2010term outcomes of 60 consecutive RIC transplants (fludarabine plus melphalan) with 120 myeloablative conditioning (MAC) transplants (total body irradiation plus cyclophosphamide) for adult high\u2010risk ALL in first or second complete remission. All transplants received a uniform strategy of pretransplant chemotherapy and GVHD prophylaxis. Compared to MAC transplants, RIC transplants had older age (46 years vs. 33 years, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and higher proportions of transplantation using peripheral blood (93.3% vs. 13.3%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) but otherwise showed similar characteristics. After a median follow\u2010up of 67 months, RIC transplants showed comparable nonrelapse mortality (21.2% vs. 24.3%) and disease\u2010free survival (50.8% vs. 54.9%) to MAC transplants, although relapse risk was higher (34.2% vs. 26.4%; HR, 2.07; <jats:italic>P<\/jats:italic>\u2009=\u20090.019) in multivariate analysis. Other independent factors associated with better outcomes were the presence of chronic GVHD and transplantation in first complete remission. Interestingly, the negative impact of RIC on relapse risk was seen only for Philadelphia\u2010positive ALL transplants (32.7% vs. 19.6%; HR, 3.46; <jats:italic>P<\/jats:italic>\u2009=\u20090.020), while no difference was found between RIC and MAC for Philadelphia\u2010negative ALL transplants (35.0% vs. 32.1%; HR, 1.39; <jats:italic>P<\/jats:italic>\u2009=\u20090.429). RIC can be considered as a reasonable choice for providing a sufficient long\u2010term graft\u2010versus\u2010leukemia effect for adult high\u2010risk ALL patients ineligible for MAC. Am. J. Hematol. 88:634\u2013641, 2013. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23465","type":"journal-article","created":{"date-parts":[[2013,4,26]],"date-time":"2013-04-26T08:10:53Z","timestamp":1366963853000},"page":"634-641","source":"Crossref","is-referenced-by-count":40,"title":["Comparable long\u2010term outcomes after reduced\u2010intensity conditioning versus myeloablative conditioning allogeneic stem cell transplantation for adult high\u2010risk acute lymphoblastic leukemia in complete remission"],"prefix":"10.1002","volume":"88","author":[{"given":"Ki\u2010Seong","family":"Eom","sequence":"first","affiliation":[{"name":"Department of Hematology Catholic BMT Center, College of Medicine, The Catholic University of Korea Seoul Republic of Korea (South Korea)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung\u2010Hwan","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Hematology Catholic BMT Center, College of 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