2021 EBMT | TBF program can improve disease-free survival of AML patients in complete remission

F.
Sora is equivalent to a recent report, compared with busulfan + fludarabine (BUFLU) (Sora F et al.
Biol Blood Marrow Transplant.
2020), cytepa + busulfan + fludarabine (TBF) The pretreatment program can reduce the risk of recurrence in patients with acute myeloid leukemia (AML) in the first and second remission (CR1/CR2) stages.

It is assumed that TBF will also outperform other pretreatment programs in terms of its anti-leukemia effect.

A retrospective study by F.
Sora et al.
compared the effects of TBF regimens with other regimens on AML patients, and the results were announced at the 47th European Association of Blood and Bone Marrow Transplantation (EBMT 2021) in 2021.

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Research methods The study included 590 AML patients who used TBF (n=221) or other treatment options (n=369).
Other treatment options include full-dose systemic radiotherapy (TBI; n=190) or other non-TBI-non-TBF programs (N=179; including BUCY, BUFLU, Thiotepa-FLU, FLU MEL).

The patients were newly diagnosed AML (n=516) and secondary AML or acute myeloid leukemia (MRC-AML) (n=74) with changes related to myelodysplasia.

The clinical characteristics of patients in the 3 groups (non-TBF-non-TBI group, TBI group and TBF group) are as follows: the median ages are 50, 37, and 52 years; the proportion of CR1 patients is 68%, 64%, and 74%, respectively (P=0.
054).

The proportions of patients transplanted from alternative donors were 45%, 57%, and 86%, respectively (p<0.
0001). Research results TBF vs TBI: The 5-year disease-free survival (DFS) rates of patients in the TBF and TBI groups were 70% and 55%, respectively (p=0.
01), and the cumulative recurrence rates were 13% and 23%, respectively (p=0.
054).

TBF vs non-TBI-non-TBF: The 5-year DFS rates of TBF and non-TBI-non-TBF groups were 70% and 41%, respectively (p<0.
001), and the cumulative recurrence rates were 13% and 30%, respectively (p=0.
0005).

In the Cox analysis (as shown below): the significant negative predictors of DFS are age> 60 years (HR: 2.
1, p=0.
0007), TBI scheme (HR: 1.
8, p=0.
01) and non-TBI-non-TBF scheme ( HR: 2.
9, p=0.
000001).

Negative predictors of recurrence were TBI regimen (HR: 1.
8, p=0.
01) and non-TBI-non-TBF regimen (HR: 2.
9, p=0.
000001).

The negative predictor of transplant-related death (TRM) is age> 60 years (HR: 2.
2, p=0.
01).

Research conclusions Compared with the TBI regimen and the non-TBI-non-TBF regimen, the TBF regimen improves the disease-free survival of CR1/CR2 AML patients by reducing the risk of recurrence.

TRM is similar in the three groups.

Reference source: F.
Sora, C.
Di Grazia, AM Raiola, et al.
THIOTEPA BUSULFAN AND FLUDARABINE (TBF) PATIENTS WITH ACUTE MYELOID LEUKEMIA IN COMPLETE REMISSION :A RETROSPECTIVE ANALYSIS ON 221 PATIENTS AND 369 CONTROLS.
The 47th Annual Meeting of the EBMT.
Abstract OS15-5.
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