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December 8, 2025Blood

Safety of myeloablative total marrow and lymphoid irradiation versus chemotherapy-based conditioning in adults with high-risk acute lymphoblastic leukemia in a limited resources setting

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Authors

MCMiguel CamposJHJosue A. Hernandez-BenitezPCPerla R. Colunga‐Pedraza

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Overview

Retrospective analysis shows TMLI has a similar toxicity profile to chemotherapy in adults with acute lymphoblastic leukemia, suggesting it may be a safe alternative.

Key Points

  • This research aimed to compare the safety and efficacy of TMLI-based conditioning versus chemotherapy-based conditioning in adults with acute lymphoblastic leukemia.
  • Retrospective multicenter study with patients aged 16-65 years with relapsed or refractory acute lymphoblastic leukemia.
  • Included patients receiving TMLI-based regimens and a historical control group receiving chemotherapy.
  • Primary outcome was 100-day non-relapse mortality, with secondary outcomes including graft failure and overall survival.
  • Twenty-two patients received TMLI; comparison group had 21 patients with chemotherapy.
  • No significant difference in non-relapse mortality rates (4.5% vs 4.8%).
  • Acute graft-versus-host disease observed in 45.5% of TMLI patients vs 61.9% in controls.

Cite This Study

Campos et al. (2025) studied this question.

synapsesocial.com/papers/69362f5a4fa91c937236dbabhttps://doi.org/10.1182/blood-2025-5998
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Also Consider

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

  1. 1Safety and feasibility of outpatient myeloablative total marrow and lymphoid Irradiation–based allogeneic transplantation in adults with high-risk acute lymphoblastic leukemia2025
  2. 2Total marrow and lymphoid irradiation (TMLI) with fludarabine-melphalan (FM) conditioning for matched donor hematopoietic cell transplant (HCT) in older patients with Relapsed/Refractory (R/R) disease2025
  3. 3Total marrow and lymphoid irradiation (2000 cGy) together with cyclophosphamide and etoposide prior to allogeneic hematopoietic cell transplantation is an effective regimen for Relapsed/Refractory leukemia, with low non-relapse mortality2025
  4. 4Total marrow irradiation based conditioning for allogeneic hematopoietic stem cell transplantation in elderly or frail patients with hematological malignancies: A single center analysis2025
  5. 5Total marrow irradiation-based conditioning for allogeneic hematopoietic stem cell transplantation in patients with hematologic malignancies: A multicenter real-world study2026