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December 8, 2025BloodOpen Access

Efficacy and safety of FLAG and CLAG regimens (Replacing Cyclophosphamide) in conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory malignant hematologic diseases

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Authors

YSYanzhi SongQWQi Wang

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Overview

Efficacy and safety of FLAG/CLAG regimens in allo-HSCT for relapsed/refractory hematologic diseases, indicating potential as a cyclophosphamide substitute.

Key Points

  • To evaluate the efficacy and safety of FLAG and CLAG regimens as conditioning for allo-HSCT in r/r malignant hematologic diseases.
  • Enrolled 132 patients with r/r malignant hematologic diseases who underwent allo-HSCT.
  • Applied conditioning regimens including fludarabine, cladribine, G-CSF, and busulfan.
  • Conducted follow-up assessments for overall survival and leukemia-free survival.
  • Achieved a 2-year leukemia-free survival rate of 47.3% and overall survival rate of 62.5%.
  • Both FLAG and CLAG regimens led to durable engraftment without significant differences in efficacy.
  • Observed rates of acute and chronic graft-versus-host disease did not significantly differ between groups.

Cite This Study

Song et al. (2025) studied this question.

synapsesocial.com/papers/69362f5a4fa91c937236dbb0https://doi.org/10.1182/blood-2025-5993
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Also Consider

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

  1. 1Salvage allogeneic hematopoietic stem cell transplantation conditioning regimens for relapsed/refractory acute leukemia: Efficacy of radiotherapy combined with CLAG vs FLAG2025
  2. 2Allogeneic hematopoietic stem cell transplantation for hematological malignancies using nonmyeloablative fludarabine, cyclophosphamide, 200 centigray total body irradiation, and post-transplant cyclophosphamide, sirolimus, and mycophenolate mofetil for graft-versus-host disease prophylaxis is associated with low non-relapse mortality.2025
  3. 3Efficacy and safety of a new cladribine-based conditioning regimen for allogeneic hematopoietic stem cell transplantation in children with relapsed or refractory acute myeloid leukemia2026
  4. 4An evolving landscape – how changing conditioning regimes can improve myelofibrosis transplant outcomes.2025
  5. 5A Baltimore-modified non-TBI conditioning for allogeneic stem cell transplantation in elderly or unfit patients with haploidentical or mismatched donors2026