{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:56:23Z","timestamp":1787756183850,"version":"build-2784847793"},"reference-count":33,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Relapse and regimen-related toxicities remain major challenges in achieving long-term survival, particularly among older patients with high-risk myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Previous studies have demonstrated the feasibility of treosulfan-based conditioning, noting stable engraftment and low non-relapse mortality (NRM) in patients undergoing HLA-matched allo-HSCT. However, data on treosulfan-based conditioning in the HLA-haploidentical transplantation (HaploT) setting are limited. We retrospectively compared conditioning with fludarabine\u2013cyclophosphamide (FC)\u2013melphalan (110 mg\/m2) and FC-treosulfan (30 g\/m2) prior to HaploT using post-transplantation cyclophosphamide (PTCy) in patients with high-risk MDS\/AML patients \u2265 50 years, transplanted from 2009\u20132021 at our institution (n = 80). After balancing patient characteristics by a matched-pair analysis, we identified twenty-one matched pairs. Two-year OS and LFS were similar among the groups (OS 66% and LFS 66%, p = 0.8 and p = 0.57). However, FC-melphalan was associated with a significantly lower probability of relapse compared to FC-treosulfan (0% vs. 24%, p = 0.006), counterbalanced by a higher NRM (33% vs. 10%, p = 0.05). Time to engraftment and incidences of acute and chronic graft-versus-host disease (GvHD) did not differ significantly. In conclusion, HaploT using FC-treosulfan in combination with PTCy in patients aged \u226550 years with MDS\/AML appears safe and effective, particularly in advanced disease stages. We confirm the favorable extramedullary toxicity profile, allowing for potential dose intensification to enhance antileukemic activity.<\/jats:p>","DOI":"10.3390\/cancers16162859","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T04:29:57Z","timestamp":1723782597000},"page":"2859","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Treosulfan-Versus Melphalan-Based Reduced Intensity Conditioning in HLA-Haploidentical Transplantation for Patients \u2265 50 Years with Advanced MDS\/AML"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8780-8015","authenticated-orcid":false,"given":"Alessia","family":"Fraccaroli","sequence":"first","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Stauffer","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Haebe","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusan","family":"Prevalsek","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Weiss","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Dorman","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidrun","family":"Drolle","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"von Bergwelt-Baildon","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Munich, a Partnership between the DKFZ Heidelberg and the University Hospital of the LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Joachim","family":"Stemmler","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9615-9432","authenticated-orcid":false,"given":"Tobias","family":"Herold","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Tischer","sequence":"additional","affiliation":[{"name":"Hematopoietic Stem Cell Transplantation Unit, Department of Medicine III, LMU University Hospital, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.bbmt.2008.03.005","article-title":"HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide","volume":"14","author":"Luznik","year":"2008","journal-title":"Biol. 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