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We retrospectively evaluated blast clearance on day 5 after melphalan, administered 11\u2009days prior to alloSCT as part of a sequential conditioning in 176 patients with active AML. Overall survival (OS) was 52% (95% confidence interval [CI] 45%\u201360%), and relapse\u2010free survival (RFS) was 47% (95% CI 40%\u201355%) at 3\u2009years. Patients who achieved early blast clearance did not show a significant improvement in OS and RFS (OS, hazard ratio [HR] HR 0.75, <jats:italic>p<\/jats:italic> 0.19; RFS, HR 0.71, <jats:italic>p<\/jats:italic> 0.09, respectively), but had a significantly lower non\u2010relapse mortality rate (HR 0.46, <jats:italic>p<\/jats:italic> 0.017). HLA\u2010mismatched donor, older age, adverse genetic risk and higher comorbidity scores were associated with inferior survival outcomes. A high initial blast count was only associated with inferior prognosis in patients receiving chemotherapy\u2010only compared to total body irradiation containing conditioning therapy. These results indicate that for patients transplanted with active AML, sensitivity to chemotherapy might be of less importance, compared to other disease\u2010 and transplant\u2010related factors.<\/jats:p>","DOI":"10.1111\/bjh.19552","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T03:30:10Z","timestamp":1717471810000},"page":"280-290","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Early blast clearance during sequential conditioning prior to allogeneic stem cell transplantation in patients with acute myeloid leukaemia"],"prefix":"10.1111","volume":"205","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1955-0709","authenticated-orcid":false,"given":"Julian","family":"Ronnacker","sequence":"first","affiliation":[{"name":"Department of Medicine A, Haematology and Oncology University Hospital Muenster  Muenster 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