{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:49:24Z","timestamp":1793321364738,"version":"4.5.0"},"reference-count":39,"publisher":"American Society of Hematology","issue":"3","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2001,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A reduced-intensity preparative regimen consisting of melphalan and a purine analog was evaluated for allogeneic transplantation in 86 patients who had a variety of hematologic malignancies and were considered poor candidates for conventional myeloablative therapies because of age or comorbidity. Seventy-eight patients received fludarabine 25 mg\/m2 daily for 5 days in combination with melphalan 180 mg\/m2 (n\u2009=\u200966) or 140 mg\/m2 (n\u2009=\u200912). Eight patients received cladribine 12 mg\/m2 continuous infusion for 5 days with melphalan 180 mg\/m2. The median age was 52 years (range, 22-70 years). Disease status at transplantation was either first remission or first chronic phase in 7 patients, untreated first relapse or subsequent remission in 16 patients, and refractory leukemia or transformed chronic myelogenous leukemia in 63 patients. Nonrelapse mortality rates on day 100 were 37.4% for the fludarabine\/melphalan combination and 87.5% for the cladribine\/melphalan combination. The median percentage of donor cells at 1 month in 75 patients was 100% (range, 0%-100%). The probability of grade 2-4 and 3-4 acute graft-versus-host disease was 0.49 (95% CI, 0.38-0.60) and 0.29 (95% CI, 0.18-0.41), respectively. Disease-free survival at 1 year was 57% for patients in first remission or chronic phase and 49% for patients with untreated first relapse or in a second or later remission. On multivariate analysis the strongest predictor for disease-free survival was a good or intermediate risk category. In summary, fludarabine\/melphalan combinations are feasible in older patients with associated comorbidities, and long-term disease control can be achieved with reduced-intensity conditioning in this population.<\/jats:p>","DOI":"10.1182\/blood.v97.3.631","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T12:46:40Z","timestamp":1027774000000},"page":"631-637","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":512,"title":["Melphalan and purine analog\u2013containing preparative regimens: reduced-intensity conditioning for patients with hematologic malignancies undergoing allogeneic progenitor cell transplantation"],"prefix":"10.1182","volume":"97","author":[{"given":"Sergio","family":"Giralt","sequence":"first","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter F.","family":"Thall","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issa","family":"Khouri","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira","family":"Braunschweig","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Ippolitti","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Claxton","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Donato","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, 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Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Anderlini","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Gajewski","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Kornblau","sequence":"additional","affiliation":[{"name":"From the Department of Blood and Bone Marrow Transplantation and Biomathematics, University of Texas MD Anderson Cancer Center, Houston, 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