{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:29:22Z","timestamp":1777955362783,"version":"3.51.4"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Bone Marrow Transplant"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>It is uncertain whether FLU\/BU4 regimens, classified as myeloablative conditioning (MAC), improve prognosis compared to conventional MAC regimens (conv-MAC) such as CY\/TBI and BU\/CY. We compared FLU\/BU4 with conv-MAC among 6551 patients (FLU\/BU4 905, conv-MAC 5646), including acute myeloid leukemia (AML) patients aged 16\u201359 who received a first allogeneic transplantation from the Japanese nationwide registry. The primary endpoint was overall survival (OS), while secondary endpoints were treatment-related mortality (TRM) and relapse at 3 years. Results indicated comparable OS for conv-MAC regimens among the entire cohort (3-year OS: FLU\/BU4 50.4% vs. conv-MAC 55.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Subgroup analysis focusing on elderly patients (aged 50\u201359) indicated that FLU\/BU4 showed a statistically significant improvement in OS (47.0% vs. 42.8%, <jats:italic>p<\/jats:italic>\u2009=\u20090.036). Notably, for patients in this cohort transplanted at complete remission (CR), FLU\/BU4 demonstrated a substantial advantage over conv-MAC with superior OS (HR 0.75, <jats:italic>p<\/jats:italic>\u2009=\u20090.046), lower TRM (HR 0.66, <jats:italic>p<\/jats:italic>\u2009=\u20090.035), and comparable relapse (HR 0.84, <jats:italic>p<\/jats:italic>\u2009=\u20090.390). These benefits were not observed in elderly patients transplanted at non-CR or in other age groups. In summary, our findings suggest that FLU\/BU4 regimen, rather than conv-MAC, may be preferable in MAC-tolerant AML patients, aged 50\u201359 at CR status. This treatment improves survival by reducing TRM without increasing relapse risk.<\/jats:p>","DOI":"10.1038\/s41409-025-02573-7","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T03:14:57Z","timestamp":1743822897000},"page":"804-810","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Improved post-transplant outcomes for elderly acute myeloid leukemia patients conditioned with FLU\/BU4 rather than conventional MAC regimens"],"prefix":"10.1038","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1827-8081","authenticated-orcid":false,"given":"Takuya","family":"Shimizu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9662-5093","authenticated-orcid":false,"given":"Yasuyuki","family":"Arai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8959-6271","authenticated-orcid":false,"given":"Tadakazu","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5895-5382","authenticated-orcid":false,"given":"Shingo","family":"Yano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-9508","authenticated-orcid":false,"given":"Yoshimitsu","family":"Shimomura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8661-3179","authenticated-orcid":false,"given":"Noriko","family":"Doki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Nishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1076-2338","authenticated-orcid":false,"given":"Satoshi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-244X","authenticated-orcid":false,"given":"Shuichi","family":"Ota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4866-9307","authenticated-orcid":false,"given":"Yoshinobu","family":"Kanda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7375-3183","authenticated-orcid":false,"given":"Takuro","family":"Kuriyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1283-4307","authenticated-orcid":false,"given":"Naoki","family":"Kurita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiro","family":"Kawakita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Hiramoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3864-0823","authenticated-orcid":false,"given":"Makoto","family":"Onizuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4404-2870","authenticated-orcid":false,"given":"Yoshiko","family":"Atsuta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1602-9775","authenticated-orcid":false,"given":"Masamitsu","family":"Yanada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,5]]},"reference":[{"key":"2573_CR1","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1182\/blood-2015-04-642652","volume":"126","author":"Y Arai","year":"2015","unstructured":"Arai Y, Takeda J, Aoki K, Kondo T, Takahashi S, Onishi Y, et al. 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