Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study

Nelli Bejanyan; Meijie Zhang; Khalid Bo-Subait; Claudio Brunstein; Hailin Wang; Erica D. Warlick; Sergio Giralt; Taiga Nishihori; Rodrigo Martino; Jakob Passweg; Ajoy Dias; Edward Copelan; Gregory Hale; Robert Peter Gale; Melhem Solh; Mohamed A. Kharfan-Dabaja; Miguel Angel Diaz; Siddhartha Ganguly; Steven Gore; Leo F. Verdonck; Nasheed M. Hossain; Natasha Kekre; Bipin Savani; Michael Byrne; Christopher Kanakry; Mitchell S. Cairo; Stefan Ciurea; Harry C. Schouten; Christopher Bredeson; Reinhold Munker; Hillard Lazarus; Jean Yves Cahn; Marjolein van Der Poel; David Rizzieri; Jean A. Yared; Cesar Freytes; Jan Cerny; Mahmoud Aljurf; Neil D. Palmisiano; Attaphol Pawarode; Vera Ulrike Bacher; Michael R. Grunwald; Sunita Nathan; Baldeep Wirk; Gerhard C. Hildebrandt; Sachiko Seo; Richard F. Olsson; Biju George; Marcos de Lima; Christopher S. Hourigan; Brenda M. Sandmaier; Mark Litzow; Partow Kebriaei; Wael Saber; Daniel Weisdorf

doi:10.1016/j.bbmt.2020.09.026

Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study

Nelli Bejanyan, Meijie Zhang, Khalid Bo-Subait, Claudio Brunstein, Hailin Wang, Erica D. Warlick, Sergio Giralt, Taiga Nishihori, Rodrigo Martino, Jakob Passweg, Ajoy Dias, Edward Copelan, Gregory Hale, Robert Peter Gale, Melhem Solh, Mohamed A. Kharfan-Dabaja, Miguel Angel Diaz, Siddhartha Ganguly, Steven Gore, Leo F. VerdonckNasheed M. Hossain, Natasha Kekre, Bipin Savani, Michael Byrne, Christopher Kanakry, Mitchell S. Cairo, Stefan Ciurea, Harry C. Schouten, Christopher Bredeson, Reinhold Munker, Hillard Lazarus, Jean Yves Cahn, Marjolein van Der Poel, David Rizzieri, Jean A. Yared, Cesar Freytes, Jan Cerny, Mahmoud Aljurf, Neil D. Palmisiano, Attaphol Pawarode, Vera Ulrike Bacher, Michael R. Grunwald, Sunita Nathan, Baldeep Wirk, Gerhard C. Hildebrandt, Sachiko Seo, Richard F. Olsson, Biju George, Marcos de Lima, Christopher S. Hourigan, Brenda M. Sandmaier, Mark Litzow, Partow Kebriaei, Wael Saber, Daniel Weisdorf

Research output: Contribution to journal › Article › peer-review

26 Scopus citations

Abstract

Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR],.74; 95% confidence interval [CI],.62 to.88; P <.001) but significantly greater relapse risk (HR, 1.54; 95% CI, 1.35 to 1.76; P <.001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95% CI, 1.07 to 1.33; P =.001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR,.83; 95% CI,.68 to 1.00; P =.051) and significantly higher relapse risk (HR, 1.23; 95% CI, 1.08 to 1.41; P =.002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.

Original language	English
Pages (from-to)	68.e1-68.e9
Journal	Transplantation and Cellular Therapy
Volume	27
Issue number	1
DOIs	https://doi.org/10.1016/j.bbmt.2020.09.026
State	Published - Jan 2021

Bibliographical note

Publisher Copyright:
© 2020 American Society for Transplantation and Cellular Therapy

Funding

Financial disclosure: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement U24CA076518 with the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID); Grant/Cooperative Agreement U24HL138660 with the NHLBI and NCI; Grant U24CA233032 from the NCI; Grants OT3 HL147741, R21 HL140314, and U01 HL128568 from the NHLBI; Contract HHSH250201700006C with the Health Resources and Services Administration (HRSA); Grants N00014-18-1-2888 and N00014-17-1-2850 from the Office of Naval Research; subaward from prime Contract Award SC1MC31881-01-00 with the HRSA; subawards from Prime Grant awards R01 HL131731 and R01 HL126589 from the NHLBI; subawards from prime Grant Awards 5P01CA111412, 5R01 HL129472, R01 CA152108, 1R01 HL131731, 1U01 AI126612, and 1R01 CA231141 from the NIH; and commercial funds from Actinium Pharmaceuticals, Adaptive Biotechnologies, Allovir, Amgen, Anonymous donation to the Medical College of Wisconsin, Anthem, Astellas Pharma US, Atara Biotherapeutics, BARDA, Be the Match Foundation, bluebird bio, Boston Children's Hospital, Bristol Myers Squibb, Celgene, Children's Hospital of Los Angeles, Chimerix, City of Hope Medical Center, CSL Behring, CytoSen Therapeutics, Daiichi Sankyo, Dana-Farber Cancer Institute, Enterprise Science and Computing, Fred Hutchinson Cancer Research Center; Gamida-Cell, Genzyme, Gilead Sciences, GlaxoSmithKline, HistoGenetics, Immucor, Incyte, Janssen Biotech, Janssen Pharmaceuticals, Janssen Research & Development, Janssen Scientific Affairs, Japan Hematopoietic Cell Transplantation Data Center, Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, Kite Pharma, Kyowa Kirin, Magenta Therapeutics, Mayo Clinic and Foundation Rochester, Medac, Mediware, Memorial Sloan Kettering Cancer Center, Merck & Company, Mesoblast, MesoScale Diagnostics, Millennium, Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program, Novartis Oncology, Novartis Pharmaceuticals, Omeros, Oncoimmune, OptumHealth, Orca Biosystems, PCORI, Pfizer, Phamacyclics, PIRCHE, Regeneron Pharmaceuticals, REGiMMUNE, Sanofi Genzyme, Seattle Genetics, Shire; Sobi, Spectrum Pharmaceuticals, St Baldrick's Foundation, Swedish Orphan Biovitrum, Takeda Oncology, The Medical College of Wisconsin, University of Minnesota, University of Pittsburgh, University of Texas MD Anderson, University of Wisconsin-Madison; Viracor Eurofins, and Xenikos BV. The views expressed in this article do not reflect the official policy or position of the NIH, the Department of the Navy, the Department of Defense, HRSA, or any other agency of the US Government. Financial disclosyure: The CIBMTR is supported primarily by Public Health Service Grant/Cooperative Agreement U24CA076518 with the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI), and the National Institute of Allergy and Infectious Diseases (NIAID); Grant/Cooperative Agreement U24HL138660 with the NHLBI and NCI; Grant U24CA233032 from the NCI; Grants OT3 HL147741, R21 HL140314, and U01 HL128568 from the NHLBI; Contract HHSH250201700006C with the Health Resources and Services Administration (HRSA); Grants N00014-18-1-2888 and N00014-17-1-2850 from the Office of Naval Research; subaward from prime Contract Award SC1MC31881-01-00 with the HRSA; subawards from Prime Grant awards R01 HL131731 and R01 HL126589 from the NHLBI; subawards from prime Grant Awards 5P01CA111412, 5R01 HL129472, R01 CA152108, 1R01 HL131731, 1U01 AI126612, and 1R01 CA231141 from the NIH; and commercial funds from Actinium Pharmaceuticals, Adaptive Biotechnologies, Allovir, Amgen, Anonymous donation to the Medical College of Wisconsin, Anthem, Astellas Pharma US, Atara Biotherapeutics, BARDA, Be the Match Foundation, bluebird bio, Boston Children's Hospital, Bristol Myers Squibb, Celgene, Children's Hospital of Los Angeles, Chimerix, City of Hope Medical Center, CSL Behring, CytoSen Therapeutics, Daiichi Sankyo, Dana-Farber Cancer Institute, Enterprise Science and Computing, Fred Hutchinson Cancer Research Center; Gamida-Cell, Genzyme, Gilead Sciences, GlaxoSmithKline, HistoGenetics, Immucor, Incyte, Janssen Biotech, Janssen Pharmaceuticals, Janssen Research & Development, Janssen Scientific Affairs, Japan Hematopoietic Cell Transplantation Data Center, Jazz Pharmaceuticals, Karius, Karyopharm Therapeutics, Kite Pharma, Kyowa Kirin, Magenta Therapeutics, Mayo Clinic and Foundation Rochester, Medac, Mediware, Memorial Sloan Kettering Cancer Center, Merck & Company, Mesoblast, MesoScale Diagnostics, Millennium, Miltenyi Biotec, Mundipharma EDO, National Marrow Donor Program, Novartis Oncology, Novartis Pharmaceuticals, Omeros, Oncoimmune, OptumHealth, Orca Biosystems, PCORI, Pfizer, Phamacyclics, PIRCHE, Regeneron Pharmaceuticals, REGiMMUNE, Sanofi Genzyme, Seattle Genetics, Shire; Sobi, Spectrum Pharmaceuticals, St Baldrick's Foundation, Swedish Orphan Biovitrum, Takeda Oncology, The Medical College of Wisconsin, University of Minnesota, University of Pittsburgh, University of Texas MD Anderson, University of Wisconsin-Madison; Viracor Eurofins, and Xenikos BV. The views expressed in this article do not reflect the official policy or position of the NIH, the Department of the Navy, the Department of Defense, HRSA, or any other agency of the US Government. Conflict of interest statement: There are no conflicts of interest to disclose. Financial disclosure: See Acknowledgments on page XXX.

Funders	Funder number
CytoSen Therapeutics, Inc.
Hope Medical Center
Magenta Therapeutics
Orca Biosystems
National Institutes of Health (NIH)
U.S. Department of Defense
Office of Naval Research Naval Academy	5R01 HL129472, R01 HL131731, 1R01 HL131731, 5P01CA111412, R01 HL126589, SC1MC31881-01-00, 1U01 AI126612, R01 CA152108, 1R01 CA231141
Office of Naval Research Naval Academy
National Heart, Lung, and Blood Institute (NHLBI)	U24HL138660
National Heart, Lung, and Blood Institute (NHLBI)
National Childhood Cancer Registry – National Cancer Institute	U24CA076518
National Childhood Cancer Registry – National Cancer Institute
National Institute of Allergy and Infectious Diseases	R21 HL140314, HHSH250201700006C, OT3 HL147741, U24CA233032, U01 HL128568
National Institute of Allergy and Infectious Diseases
Health Resources and Services Administration	N00014-17-1-2850, N00014-18-1-2888
Health Resources and Services Administration
Mayo Clinic Rochester
Bristol-Myers Squibb
Pfizer
GlaxoSmithKline
Janssen Research and Development
Gilead Sciences
Janssen Biotech
St. Baldrick's Foundation
Patient-Centered Outcomes Research Institute
Celgene
Children's Hospital Boston
Dana-Farber Cancer Institute
CSL Behring GmbH
Janssen Pharmaceuticals
BC Children’s Hospital
Government of South Australia
Janssen Scientific Affairs LLC
Daiichi Sankyo Company, Limited
Kyowa Hakko Kirin

Keywords

AML
DRI
MDS
Myeloablative
RIC

ASJC Scopus subject areas

Immunology and Allergy
Molecular Medicine
Hematology
Cell Biology
Transplantation

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Bejanyan, N., Zhang, M., Bo-Subait, K., Brunstein, C., Wang, H., Warlick, E. D., Giralt, S., Nishihori, T., Martino, R., Passweg, J., Dias, A., Copelan, E., Hale, G., Gale, R. P., Solh, M., Kharfan-Dabaja, M. A., Diaz, M. A., Ganguly, S., Gore, S., ... Weisdorf, D. (2021). Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study. Transplantation and Cellular Therapy, 27(1), 68.e1-68.e9. https://doi.org/10.1016/j.bbmt.2020.09.026

Bejanyan, Nelli ; Zhang, Meijie ; Bo-Subait, Khalid et al. / Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index : A Center for International Blood and Marrow Transplant Research Study. In: Transplantation and Cellular Therapy. 2021 ; Vol. 27, No. 1. pp. 68.e1-68.e9.

@article{1afdc6a3e96e4c79be51a71fe0e1e69c,

title = "Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study",

abstract = "Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR],.74; 95\% confidence interval [CI],.62 to.88; P <.001) but significantly greater relapse risk (HR, 1.54; 95\% CI, 1.35 to 1.76; P <.001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95\% CI, 1.07 to 1.33; P =.001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR,.83; 95\% CI,.68 to 1.00; P =.051) and significantly higher relapse risk (HR, 1.23; 95\% CI, 1.08 to 1.41; P =.002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.",

keywords = "AML, DRI, MDS, Myeloablative, RIC",

author = "Nelli Bejanyan and Meijie Zhang and Khalid Bo-Subait and Claudio Brunstein and Hailin Wang and Warlick, \{Erica D.\} and Sergio Giralt and Taiga Nishihori and Rodrigo Martino and Jakob Passweg and Ajoy Dias and Edward Copelan and Gregory Hale and Gale, \{Robert Peter\} and Melhem Solh and Kharfan-Dabaja, \{Mohamed A.\} and Diaz, \{Miguel Angel\} and Siddhartha Ganguly and Steven Gore and Verdonck, \{Leo F.\} and Hossain, \{Nasheed M.\} and Natasha Kekre and Bipin Savani and Michael Byrne and Christopher Kanakry and Cairo, \{Mitchell S.\} and Stefan Ciurea and Schouten, \{Harry C.\} and Christopher Bredeson and Reinhold Munker and Hillard Lazarus and Cahn, \{Jean Yves\} and \{van Der Poel\}, Marjolein and David Rizzieri and Yared, \{Jean A.\} and Cesar Freytes and Jan Cerny and Mahmoud Aljurf and Palmisiano, \{Neil D.\} and Attaphol Pawarode and Bacher, \{Vera Ulrike\} and Grunwald, \{Michael R.\} and Sunita Nathan and Baldeep Wirk and Hildebrandt, \{Gerhard C.\} and Sachiko Seo and Olsson, \{Richard F.\} and Biju George and \{de Lima\}, Marcos and Hourigan, \{Christopher S.\} and Sandmaier, \{Brenda M.\} and Mark Litzow and Partow Kebriaei and Wael Saber and Daniel Weisdorf",

note = "Publisher Copyright: {\textcopyright} 2020 American Society for Transplantation and Cellular Therapy",

year = "2021",

month = jan,

doi = "10.1016/j.bbmt.2020.09.026",

language = "English",

volume = "27",

pages = "68.e1--68.e9",

number = "1",

}

Bejanyan, N, Zhang, M, Bo-Subait, K, Brunstein, C, Wang, H, Warlick, ED, Giralt, S, Nishihori, T, Martino, R, Passweg, J, Dias, A, Copelan, E, Hale, G, Gale, RP, Solh, M, Kharfan-Dabaja, MA, Diaz, MA, Ganguly, S, Gore, S, Verdonck, LF, Hossain, NM, Kekre, N, Savani, B, Byrne, M, Kanakry, C, Cairo, MS, Ciurea, S, Schouten, HC, Bredeson, C, Munker, R, Lazarus, H, Cahn, JY, van Der Poel, M, Rizzieri, D, Yared, JA, Freytes, C, Cerny, J, Aljurf, M, Palmisiano, ND, Pawarode, A, Bacher, VU, Grunwald, MR, Nathan, S, Wirk, B, Hildebrandt, GC, Seo, S, Olsson, RF, George, B, de Lima, M, Hourigan, CS, Sandmaier, BM, Litzow, M, Kebriaei, P, Saber, W & Weisdorf, D 2021, 'Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study', Transplantation and Cellular Therapy, vol. 27, no. 1, pp. 68.e1-68.e9. https://doi.org/10.1016/j.bbmt.2020.09.026

Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study. / Bejanyan, Nelli; Zhang, Meijie; Bo-Subait, Khalid et al.
In: Transplantation and Cellular Therapy, Vol. 27, No. 1, 01.2021, p. 68.e1-68.e9.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index

T2 - A Center for International Blood and Marrow Transplant Research Study

AU - Bejanyan, Nelli

AU - Zhang, Meijie

AU - Bo-Subait, Khalid

AU - Brunstein, Claudio

AU - Wang, Hailin

AU - Warlick, Erica D.

AU - Giralt, Sergio

AU - Nishihori, Taiga

AU - Martino, Rodrigo

AU - Passweg, Jakob

AU - Dias, Ajoy

AU - Copelan, Edward

AU - Hale, Gregory

AU - Gale, Robert Peter

AU - Solh, Melhem

AU - Kharfan-Dabaja, Mohamed A.

AU - Diaz, Miguel Angel

AU - Ganguly, Siddhartha

AU - Gore, Steven

AU - Verdonck, Leo F.

AU - Hossain, Nasheed M.

AU - Kekre, Natasha

AU - Savani, Bipin

AU - Byrne, Michael

AU - Kanakry, Christopher

AU - Cairo, Mitchell S.

AU - Ciurea, Stefan

AU - Schouten, Harry C.

AU - Bredeson, Christopher

AU - Munker, Reinhold

AU - Lazarus, Hillard

AU - Cahn, Jean Yves

AU - van Der Poel, Marjolein

AU - Rizzieri, David

AU - Yared, Jean A.

AU - Freytes, Cesar

AU - Cerny, Jan

AU - Aljurf, Mahmoud

AU - Palmisiano, Neil D.

AU - Pawarode, Attaphol

AU - Bacher, Vera Ulrike

AU - Grunwald, Michael R.

AU - Nathan, Sunita

AU - Wirk, Baldeep

AU - Hildebrandt, Gerhard C.

AU - Seo, Sachiko

AU - Olsson, Richard F.

AU - George, Biju

AU - de Lima, Marcos

AU - Hourigan, Christopher S.

AU - Sandmaier, Brenda M.

AU - Litzow, Mark

AU - Kebriaei, Partow

AU - Saber, Wael

AU - Weisdorf, Daniel

PY - 2021/1

Y1 - 2021/1

N2 - Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR],.74; 95% confidence interval [CI],.62 to.88; P <.001) but significantly greater relapse risk (HR, 1.54; 95% CI, 1.35 to 1.76; P <.001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95% CI, 1.07 to 1.33; P =.001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR,.83; 95% CI,.68 to 1.00; P =.051) and significantly higher relapse risk (HR, 1.23; 95% CI, 1.08 to 1.41; P =.002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.

AB - Compared with reduced-intensity conditioning (RIC), myeloablative conditioning (MAC) is generally associated with lower relapse risk after allogeneic hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS). However, disease-specific risk factors in AML/MDS can further inform when MAC and RIC may yield differential outcomes. We analyzed HCT outcomes stratified by the Disease Risk Index (DRI) in 4387 adults (age 40 to 65 years) to identify the impact of conditioning intensity. In the low/intermediate-risk DRI cohort, RIC was associated with lower nonrelapse mortality (NRM) (hazard ratio [HR],.74; 95% confidence interval [CI],.62 to.88; P <.001) but significantly greater relapse risk (HR, 1.54; 95% CI, 1.35 to 1.76; P <.001) and thus inferior disease-free survival (DFS) (HR, 1.19; 95% CI, 1.07 to 1.33; P =.001). In the high/very high-risk DRI cohort, RIC was associated with marginally lower NRM (HR,.83; 95% CI,.68 to 1.00; P =.051) and significantly higher relapse risk (HR, 1.23; 95% CI, 1.08 to 1.41; P =.002), leading to similar DFS using either RIC or MAC. These data support MAC over RIC as the preferred conditioning intensity for patients with AML/MDS with low/intermediate-risk DRI, but with a similar benefit as RIC in high/very high-risk DRI. Novel MAC regimens with less toxicity could benefit all patients, but more potent antineoplastic approaches are needed for the high/very-high risk DRI group.

KW - AML

KW - DRI

KW - MDS

KW - Myeloablative

KW - RIC

UR - https://www.scopus.com/pages/publications/85095870377

UR - https://www.scopus.com/inward/citedby.url?scp=85095870377&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2020.09.026

DO - 10.1016/j.bbmt.2020.09.026

M3 - Article

C2 - 33010430

AN - SCOPUS:85095870377

SN - 2666-6367

VL - 27

SP - 68.e1-68.e9

JO - Transplantation and Cellular Therapy

JF - Transplantation and Cellular Therapy

IS - 1

ER -

Bejanyan N, Zhang M, Bo-Subait K, Brunstein C, Wang H, Warlick ED et al. Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study. Transplantation and Cellular Therapy. 2021 Jan;27(1):68.e1-68.e9. doi: 10.1016/j.bbmt.2020.09.026

Myeloablative Conditioning for Allogeneic Transplantation Results in Superior Disease-Free Survival for Acute Myelogenous Leukemia and Myelodysplastic Syndromes with Low/Intermediate but not High Disease Risk Index: A Center for International Blood and Marrow Transplant Research Study

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

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