{"doi":"10.1038/s41409-024-02491-0","title":"Fludarabine melphalan reduced intensity conditioning vs radiation-based myeloablative conditioning in patients undergoing allogeneic transplantation for acute myeloid leukemia with measurable residual disease","abstract":"Patients with AML and measurable residual disease (MRD) undergoing allogeneic hematopoietic cell transplantation (HCT) may benefit from myeloablative conditioning (MAC) when feasible to reduce relapse risk. Fludarabine-Melphalan (FluMel) is a common reduced intensity conditioning (RIC) regimen; however, data in MRD+ patients is sparse. We performed a retrospective review of AML patients who underwent their first HCT (2016-2021) without morphologic disease at City of Hope who had pre-transplant marrow evaluated for MRD using multicolor flow cytometry (MFC) and received radiation-based MAC or FluMel conditioning. We identified 312 patients; 44 with MRD+ disease pre-HCT. The 24-month overall survival (OS), leukemia-free survival (LFS) and cumulative incidence of relapse (CIR) were 47.7%, 40.9%, and 38.6% in MRD+, and 78.0%, 73.9%, and 14.6% in MRD- patients. Radiation-based MAC was given to 136 (43.5%) patients (n = 20 with MRD+) and FluMel was given to 174 (55.8%) patients (n = 24 with MRD+). In patients with MRD+, there was no statistically significant difference between those who received MAC vs. FluMel in 24-month OS (60% vs. 38%, p = 0.21), or CIR (35% vs. 42%, p = 0.59), respectively. Our data substantiates the adverse impact of MRD in patients with AML undergoing HCT; FluMel is a reasonable option for MRD+ patients unfit for MAC.","journal":"Bone Marrow Transplantation","year":2024,"id":507672,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9476,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":780091,"name":"Michelle Afkhami","orcid":"0000-0001-5830-6158","position":1,"is_corresponding":false},{"id":318404,"name":"Dongyun Yang","orcid":"0000-0003-0736-4977","position":2,"is_corresponding":false},{"id":319462,"name":"Sally Mokhtari","orcid":null,"position":3,"is_corresponding":false},{"id":1110329,"name":"Yazeed Samara","orcid":null,"position":4,"is_corresponding":false},{"id":955034,"name":"Hoda Pourhassan","orcid":"0000-0003-3862-4612","position":5,"is_corresponding":false},{"id":660620,"name":"Brian Ball","orcid":"0000-0001-8625-7023","position":6,"is_corresponding":false},{"id":387637,"name":"Amandeep Salhotra","orcid":"0000-0002-9302-5041","position":7,"is_corresponding":false},{"id":284126,"name":"Vaibhav Agrawal","orcid":"0000-0002-6383-3777","position":8,"is_corresponding":false},{"id":387639,"name":"Karamjeet Sandhu","orcid":"0000-0001-8024-8484","position":9,"is_corresponding":false},{"id":838341,"name":"Amrita Desai","orcid":null,"position":10,"is_corresponding":false},{"id":660619,"name":"Salman Otoukesh","orcid":"0000-0002-7782-8805","position":11,"is_corresponding":false},{"id":432775,"name":"Shukaib Arslan","orcid":"0000-0002-8447-9607","position":12,"is_corresponding":false},{"id":449638,"name":"Idoroenyi Amanam","orcid":"0000-0003-4819-4628","position":13,"is_corresponding":false},{"id":432776,"name":"Paul Koller","orcid":"0000-0003-3830-5320","position":14,"is_corresponding":false},{"id":735044,"name":"Jose Tinajero","orcid":"0000-0002-1175-3564","position":15,"is_corresponding":false},{"id":432774,"name":"Ahmed Aribi","orcid":"0000-0003-2497-3176","position":16,"is_corresponding":false},{"id":233349,"name":"Ibrahim Aldoss","orcid":"0000-0001-9564-4498","position":17,"is_corresponding":false},{"id":380972,"name":"Pamela S. 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