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December 8, 2025BloodOpen Access

Superior long-term outcomes with fludarabine and melphalan reduced intensity regimen in older AML/MDS patients undergoing allogeneic stem cell transplantation: An analysis of CIBMTR data

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Authors

HEHany ElmariahLMLori MufflyMNMariam T. Nawas

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Overview

Analysis reveals improved survival in older AML/MDS patients undergoing allogeneic stem cell transplantation with melphalan-based regimens, suggesting optimal conditioning approaches.

Key Points

  • This analysis aims to evaluate the long-term outcomes of fludarabine and melphalan-based regimens in older patients undergoing allogeneic stem cell transplantation for AML or MDS.
  • Analyzed 11,731 patients aged ≥50 years from CIBMTR registry
  • Compared five fludarabine-based reduced intensity conditioning regimens
  • Utilized propensity score inverse probability weighting to minimize bias
  • FM100 and FM140 showed improved 3-year overall survival at 53% compared to other regimens
  • FM regimens led to significantly lower relapse rates than FB2, FCT, and FT
  • Higher early transplant-related mortality noted in FM regimens, but no long-term impact beyond 6 months

Cite This Study

Elmariah et al. (2025) studied this question.

synapsesocial.com/papers/693624d44fa91c937236cffdhttps://doi.org/10.1182/blood-2025-109
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative outcomes of fludarabine-melphalan versus fludarabine-busulfan reduced-intensity conditioning for allogeneic hematopoietic stem cell transplantation in patients with hematologic malignancies: A systematic review and meta-analysis2025
  2. 2An evolving landscape – how changing conditioning regimes can improve myelofibrosis transplant outcomes.2025
  3. 3Melphalan versus cyclophosphamide combined with fludarabine and low dose total body irradiation (TBI) prior to ptcy-based allogeneic transplantation2025
  4. 4Fludarabine-treosulfan versus fludarabine-melphalan or busulfan-cyclophosphamide conditioning in older AML or MDS patients – A clinical trial to registry data comparison2024 · 11 citations
  5. 5Long-term survival outcomes of allo-HCT in AML with fludarabine/melphalan conditioning and tacrolimus/sirolimus GVHD prophylaxis2025