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To further evaluate this regimen, all 252 study patients aged 50 to 70 years were compared with similar patients, who underwent allo-HCT after fludarabine\/melphalan (140\u2009mg\/m\u00b2) (FluMel) or busulfan (12.8\u2009mg\/kg)\/cyclophosphamide (120\u2009mg\/kg) (BuCy) regimens and whose data was provided by the European Society for Blood and Marrow Transplantation registry. In 1:1 propensity-score matched-paired analysis (PSA) of AML patients, there was no difference in 2-year-relapse-incidence after FluTreo compared with either FluMel (<jats:italic>n<\/jats:italic>\u2009=\u2009110, <jats:italic>p<\/jats:italic>\u2009=\u20090.28) or BuCy (<jats:italic>n<\/jats:italic>\u2009=\u200978, <jats:italic>p<\/jats:italic>\u2009=\u20090.98). However, 2-year-non-relapse-mortality (NRM) was lower compared with FluMel (<jats:italic>p<\/jats:italic>\u2009=\u20090.019) and BuCy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Consequently, 2-year-overall-survival (OS) after FluTreo was higher compared with FluMel (<jats:italic>p<\/jats:italic>\u2009=\u20090.04) and BuCy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). For MDS patients, no endpoint differences between FluTreo and FluMel (<jats:italic>n<\/jats:italic>\u2009=\u200930) were evident, whereas 2-year-OS after FluTreo was higher compared with BuCy (<jats:italic>n<\/jats:italic>\u2009=\u200925, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) due to lower 2-year-NRM. Multivariate sensitivity analysis confirmed all significant results of PSA. Consequently, FluTreo (30\u2009g\/m\u00b2) seems to retain efficacy compared with FluMel and BuCy, but is better tolerated by older patients.<\/jats:p>","DOI":"10.1038\/s41409-024-02241-2","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T13:02:18Z","timestamp":1708520538000},"page":"670-679","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Fludarabine-treosulfan versus fludarabine-melphalan or busulfan-cyclophosphamide conditioning in older AML or MDS patients \u2013 A clinical trial to registry data comparison"],"prefix":"10.1038","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5050-220X","authenticated-orcid":false,"given":"Dietrich Wilhelm","family":"Beelen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Iacobelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Koster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk-Jan","family":"Eikema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"van Biezen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0653-5332","authenticated-orcid":false,"given":"Friedrich","family":"St\u00f6lzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0873-0123","authenticated-orcid":false,"given":"Fabio","family":"Ciceri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6052-2618","authenticated-orcid":false,"given":"Wolfgang","family":"Bethge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7429-8570","authenticated-orcid":false,"given":"Peter","family":"Dreger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0728-2253","authenticated-orcid":false,"given":"Eva-Maria","family":"Wagner-Drouet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Rem\u00e9nyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Stelljes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8550-8908","authenticated-orcid":false,"given":"Miroslaw","family":"Markiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1224-091X","authenticated-orcid":false,"given":"Donal P.","family":"McLornan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Yakoub-Agha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7264-808X","authenticated-orcid":false,"given":"Mohamad","family":"Mohty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"2241_CR1","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1182\/blood-2014-02-514778","volume":"124","author":"B Gyurkocza","year":"2014","unstructured":"Gyurkocza B, Sandmaier BM. 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Simona Iacobelli, Linda Koster, Dirk-Jan Eikema, Anja van Biezen, Fabio Ciceri, P\u00e9ter Rem\u00e9nyi, Miroslaw Markiewicz. Donal McLornan and Ibrahim Yakoub-Agha have nothing to disclose. Dietrich W. Beelen and Matthias Stelljes have received honoraria from medac GmbH, have been paid to participate in a speakers\u2019 bureau by medac GmbH and received travel and accommodation expenses from medac GmbH; Friedrich St\u00f6lzel received honoraria from medac GmbH, has been paid for a consulting or advisory role by medac GmbH, has received travel, accommodation or expenses from medac GmbH; Wolfgang Bethge received honoraria from medac GmbH, has been paid for a consulting or advisory role by Gilead, Novartis, Celgene, BMS; Peter Dreger obtained grants from medac GmbH; Eva-Maria Wagner-Drouet has been paid for a consulting or advisory role by Novartis, Kite Gilead, MSD and received travel, accommodation or expenses from medac GmbH; Mohamad Mohty received lectures honoraria from medac GmbH outside the scope of this work.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}