{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:50:11Z","timestamp":1793321411426,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,12,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fludarabine with melphalan (FM) or busulfan (FB) is among the most widely used reduced\u2010intensity conditioning regimens for allogeneic hematopoietic stem cell transplantation (allo\u2010HSCT). The authors conducted a systematic review and meta\u2010analysis comparing these regimens in adult patients with hematologic malignancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of Ovid MEDLINE, Embase, and the Cochrane Library from inception through July 22, 2025, identified 17 eligible studies involving 10,396 patients. Pooled analyses were performed using a random\u2010effects model, and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the overall analysis, FM was associated with improved progression\u2010free survival (PFS) (HR, 0.90; 95% CI, 0.82\u20130.98), driven by lower relapse rates (HR, 0.69; 95% CI, 0.62\u20130.78) but increased treatment\u2010related mortality (TRM) (HR, 1.44; 95% CI, 1.10\u20131.89). There were no significant differences in overall survival (OS), grade 3\u20134 acute graft\u2010versus\u2010host disease (GVHD), or chronic GVHD. In subgroup analyses, FM significantly improved OS and PFS, primarily driven by a significant reduction in relapse risk in acute myeloid leukemia\/myelodysplastic syndrome (AML\/MDS) and elderly patients aged \u226560 years without significant differences in TRM. In contrast, for lymphoma patients, FM was associated with worse OS and higher TRM compared with FB, and no advantage in PFS, but significantly lower relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that FM may be a preferred reduced\u2010intensity regimen for AML\/MDS and elderly patients, whereas lower intensity regimens may be needed for lymphoma to reduce TRM and optimize long\u2010term survival after allo\u2010HSCT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70199","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:54:52Z","timestamp":1765043692000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of fludarabine\u2010melphalan versus fludarabine\u2010busulfan reduced\u2010intensity conditioning regimens for allogeneic hematopoietic stem cell transplantation in patients with hematologic malignancies: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8069-0408","authenticated-orcid":false,"given":"Chalothorn","family":"Wannaphut","sequence":"first","affiliation":[{"name":"Department of Internal Medicine John A. 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