FM-based PBSC transplants with PTCy
Koller PB, Othman T, Yang D Melphalan-Based Conditioning With Post-Transplant Cyclophosphamide for Peripheral Blood Stem Cell Transplantation: Donor Effect. Bone Marrow Transplantation. 2025; (doi: 10.1038/s41409-025-02523-3).
Single-center data elucidate the benefits of using fludarabine and melphalan (FM) conditioning before peripheral blood stem cell (PBSC) transplantation and post-transplant cyclophosphamide (PTCy) after the procedure. The retrospective study included 248 adult patients who underwent FM-based procedures with PTCy between January 2015 and December 2021 using matched related/unrelated (MRD/MUD), haploidentical (HI), or mismatched unrelated (MMUD) donors. The regimen of reduced-intensity conditioning plus graft-versus-host disease prophylaxis was associated with promising disease control and acceptable rates of non-relapse mortality (NRM). After adjusting for donor age, outcomes were similar across donor types, with 2-year overall survival (OS) ranging from 55%-70%, disease-free survival ranging from 48%-66%, and graft-versus-host/relapse-free survival (GRFS) ranging from 40%-59%. Age ≥35 years emerged as the most significant factor in donor selection, as it was associated with greater 2-year NRM and lower OS and GRFS.