{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:59:37Z","timestamp":1768705177770,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Total body irradiation (TBI) at a dose of 12\u2009Gy combined with cyclophosphamide (CyTBI12Gy) is one of the standard myeloablative regimens for patients with acute myeloid leukemia (AML) treated with allogeneic hematopoietic cell transplantation (allo\u2010HCT). In clinical practice, cyclophosphamide may be substituted with fludarabine (FluTBI12Gy) to reduce toxicity. We retrospectively compared outcomes of CyTBI12Gy with FluTBI12Gy for patients with AML treated in complete remission (CR) with allo\u2010HCT from either a matched sibling or unrelated donor. Of 1684 adults who met inclusion criteria, 109 patients in each group were included in a matched\u2010pair analysis. The cumulative incidence of relapse at 2\u2009years was 25% in the FluTBI12Gy compared to 28% in the CyTBI12Gy group (<jats:italic>p<\/jats:italic>\u00a0=\u2009.44) while non\u2010relapse mortality (NRM) was 17% versus 19%, (<jats:italic>p<\/jats:italic>\u00a0=\u2009.89) respectively. The rates of leukemia\u2010free survival and overall survival were 65% versus 54% (<jats:italic>p<\/jats:italic>\u00a0=\u2009.28) and 70% versus 60.5% (<jats:italic>p<\/jats:italic>\u00a0=\u2009.17). Cumulative incidence of grade 2\u20134 acute graft\u2010versus\u2010host disease (GVHD) was significantly lower for FluTBI12Gy than CyTBI12Gy (16% vs. 34%, <jats:italic>p<\/jats:italic>\u00a0=\u2009.005), while the incidences of grade 3\u20134 acute GVHD and chronic GVHD did not differ significantly. The probability of GVHD and relapse\u2010free survival was 49% in the FluTBI12Gy and 41% in the CyTBI12Gy group (<jats:italic>p<\/jats:italic>\u00a0=\u2009.17). We conclude that for patients with AML treated with allo\u2010HCT in CR, cyclophosphamide may be substituted with fludarabine in a regimen based on TBI at a dose of 12\u2009Gy without negative impact on the efficacy. FluTBI12Gy is associated with reduced risk of grade 2\u20134 acute GVHD and encouraging survival rates.<\/jats:p>","DOI":"10.1002\/ajh.26825","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T19:20:15Z","timestamp":1673378415000},"page":"580-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fludarabine versus cyclophospamide in combination with myeloablative total body irradiation as conditioning for patients with acute myeloid leukemia treated with allogeneic hematopoietic cell transplantation. A study from the Acute Leukemia Working Party of the <scp>European Society for Blood and Marrow Transplantation<\/scp>"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4827-4401","authenticated-orcid":false,"given":"Sebastian","family":"Giebel","sequence":"first","affiliation":[{"name":"Department of Bone Marrow Transplantation and Onco\u2010Hematology Maria Sklodowska\u2010Curie National Research Institute of Oncology, Gliwice Branch  Gliwice Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myriam","family":"Labopin","sequence":"additional","affiliation":[{"name":"AP\u2010HP, H\u00f4pital Saint\u2010Antoine Sorbonne Universit\u00e9, INSERM UMR\u2010S 938, CRSA, Service d'H\u00e9matologie Clinique et Th\u00e9rapie Cellulaire  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Dept. of Hematology and Stem Cell Transplantation University Hospital  Essen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-3919","authenticated-orcid":false,"given":"Ryszard","family":"Swoboda","sequence":"additional","affiliation":[{"name":"Department of Bone Marrow Transplantation and Onco\u2010Hematology Maria Sklodowska\u2010Curie National Research Institute of Oncology, Gliwice Branch  Gliwice Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Maertens","sequence":"additional","affiliation":[{"name":"Dept. of Hematology University Hospital Gasthuisberg  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Henri","family":"Bourhis","sequence":"additional","affiliation":[{"name":"Department of Hematology Gustave Roussy Cancer Campus BMT Service  Villejuif France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Grillo","sequence":"additional","affiliation":[{"name":"Hematology Department Asst Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Urpu","family":"Salmenniemi","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation Unit HUCH Comprehensive Cancer Center  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inken","family":"Hilgendorf","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin II, (Abt. H\u00e4matologie und Onkologie) Universitaetsklinikum Jena  Jena Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolaus","family":"Kr\u00f6ger","sequence":"additional","affiliation":[{"name":"Bone Marrow Transplantation Centre University Hospital Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1897-0227","authenticated-orcid":false,"given":"Xavier","family":"Poir\u00e9","sequence":"additional","affiliation":[{"name":"Dept. of Haematology Cliniques Universitaires St. Luc  Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan J.","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"Department of Hematology Erasmus MC Cancer Institute, University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mutlu","family":"Arat","sequence":"additional","affiliation":[{"name":"Istanbul Florence Nightingale Hospital  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bipin","family":"Savani","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandros","family":"Spyridonidis","sequence":"additional","affiliation":[{"name":"BMT Unit University Hospital of Patras  Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0763-1265","authenticated-orcid":false,"given":"Arnon","family":"Nagler","sequence":"additional","affiliation":[{"name":"Hematology Division Chaim Sheba Medical Center  Tel\u2010Hashomer Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Mohty","sequence":"additional","affiliation":[{"name":"AP\u2010HP, H\u00f4pital Saint\u2010Antoine Sorbonne Universit\u00e9, INSERM UMR\u2010S 938, CRSA, Service d'H\u00e9matologie Clinique et Th\u00e9rapie Cellulaire  Paris France"},{"name":"Department of Hematology Hospital Saint Antoine  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-021-01227-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.121"},{"issue":"12","key":"e_1_2_9_4_1","first-page":"1273","article-title":"Impact of conditioning intensity of allogeneic transplantation for acute myeloid leukemia with genomic evidence of residual disease","volume":"38","author":"Hourigan CS","year":"2020","journal-title":"Clin Oncol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.13.3569"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.48.8114"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-020-01050-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28768"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2991\/chi.d.190218.002"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(99)00178-4"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.72.5.382"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70349-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2991\/chi.d.191207.001"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19990330)18:6<695::AID-SIM60>3.0.CO;2-O"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"issue":"3","key":"e_1_2_9_16_1","first-page":"138","article-title":"Treatment of blastic transformation of chronic granulocytic leukemia by high dose cyclophosphamide, total body irradiation and infusion of cryopreserved autologous marrow","volume":"2","author":"Buckner CD","year":"1974","journal-title":"Exp Hematol"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198312013092202"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V76.3.473.473"},{"issue":"5","key":"e_1_2_9_19_1","first-page":"781","article-title":"Cyclophosphamide toxicity","volume":"42","author":"Fraiser LH","year":"1991","journal-title":"Char Avoid Prob Drugs"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1609337"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.1.116"},{"issue":"1","key":"e_1_2_9_22_1","first-page":"45","article-title":"Pharmacokinetic and pharmacodynamic studies of fludarabine and cytosine arabinoside administered as loading boluses followed by continuous infusions after a phase I\/II study in pediatric patients with relapsed leukemias. 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