Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
December 8, 2025BloodOpen Access

Total 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) disease

View Full Paper
Ask AI
Bookmark
Share

Authors

SHSusanta HuiCity Of Hope National Medical CenterSMSally MokhtariCity of HopeSAShukaib ArslanCity Of Hope National Medical Center

Discussion

Loading...

Member takes

Implication

Phase 1 trial shows safety and survival rates for TMLI with FM in older adults with relapsed/refractory disease, indicating effective treatment.

Key Points

  • To evaluate the safety and efficacy of total marrow and lymphoid irradiation (TMLI) with fludarabine-melphalan as conditioning for HCT in older patients with high-risk disease.
  • Conducted a phase 1 trial with older adults (≥55 years) having relapsed/refractory acute leukemia or MDS.
  • Conditioning regimen included TMLI, fludarabine, and melphalan, with dose escalation for TMLI (12 to 18 Gy).
  • Monitored outcomes included engraftment, GVHD incidence, and survival; performed comprehensive correlative analyses.
  • All patients engrafted with full donor chimerism and achieved complete remission with negative MRD by day 30.
  • At 24 months, survival rates were 55% overall and progression-free; relapse and non-relapse mortality were 17% and 28%, respectively.
  • Toxicities included significant GI effects; however, GVHD and immune reconstitution remained acceptable across all doses.

Cite This Study

Hui et al. (2025) studied this question.

synapsesocial.com/papers/69362f6e4fa91c937236e0d1https://doi.org/10.1182/blood-2025-376
View Full Paper
Ask AI
Bookmark
Share

Also Consider

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

  1. 1Safety of myeloablative total marrow and lymphoid irradiation versus chemotherapy-based conditioning in adults with high-risk acute lymphoblastic leukemia in a limited resources setting2025
  2. 2Total 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
  3. 3Safety and feasibility of outpatient myeloablative total marrow and lymphoid Irradiation–based allogeneic transplantation in adults with high-risk acute lymphoblastic leukemia2025
  4. 4First-in-human phase I trial combining radiopharmaceutical therapy (RPT) using a 90y-anti-CD25 monoclonal antibody (Mab) with total marrow and lymphoid irradiation (TMLI) in relapsed or refractory (R/R) acute leukemia2025
  5. 5Total marrow irradiation based conditioning for allogeneic hematopoietic stem cell transplantation in elderly or frail patients with hematological malignancies: A single center analysis2025