Difference between revisions of "Allogeneic HSCT"

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[[#top|Back to Top]]
 
[[#top|Back to Top]]
 
</div>
 
</div>
{| class="wikitable" style="text-align:center; width:50%;"
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{{#lst:Editorial board transclusions|transplant}}
! colspan="2" align="center" style="color:white; font-size:125%; background-color:#4a1486" |'''Section editor'''
+
Unlike the other chemotherapy regimen pages, this one is not disease-specific. Rather, this is a gathering point for all allogeneic hematopoietic stem cell transplant (HSCT) conditioning regimens. Unless otherwise specified, the day before HSCT is day -1, the day of HSCT is day 0, and the day after HSCT is day +1. As with the rest of the HemOnc.org website, the focus here is on regimens used in the treatment of hematologic or oncologic conditions; there are roles for allogeneic HSCT outside of hematology/oncology but these use cases are considered to be out of scope.
|-
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| style="background-color:#F0F0F0" |[[File:T. Hilal.png|alt=|center|frameless|89x89px]]
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<br><big>These links will take you to highly related pages:
|<big>Talal Hilal, MD<br>Mayo Clinic<br>Phoenix, AZ</big><br>[[File:Social-twitter-icon.png|frameless|upright=0.1]] [https://twitter.com/THilalMD THilalMD]
+
*'''[[Cellular therapy conditioning regimens]]'''
|-
+
*'''[[Graft versus host disease|Graft versus host disease (GVHD)]]'''
|}
+
*'''[[Hepatic veno-occlusive disease|Hepatic veno-occlusive disease (VOD)]]'''
Unlike the other chemotherapy regimen pages, this one is not disease-specific. Rather, this is a gathering point for all allogeneic hematopoietic stem cell transplant (HSCT) conditioning regimens. Unless otherwise specified, the day before HSCT is day -1, the day of HSCT is day 0, and the day after HSCT is day +1.
+
*We have moved [[How I Treat]] articles to a dedicated page.</big>
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
|-
 
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|}
 
|}
 
{{TOC limit|limit=3}}
 
{{TOC limit|limit=3}}
=Guidelines=
 
=="How I Treat"==
 
*'''2020:''' Puerta-Alcalde et al. [https://doi.org/10.1182/blood.2020005884 How I perform hematopoietic stem cell transplantation on patients with a history of invasive fungal disease]
 
*'''2019:''' McCurdy & Luznik [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6872960/ How we perform haploidentical stem cell transplantation with posttransplant cyclophosphamide]
 
 
=Myeloablative regimens, all lines of therapy=
 
=Myeloablative regimens, all lines of therapy=
 
==BuCyTBI {{#subobject:44b691|Regimen=1}}==
 
==BuCyTBI {{#subobject:44b691|Regimen=1}}==
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|-
 
|-
 
|[https://doi.org/10.1056/NEJM197902153000702 Fefer et al. 1979]
 
|[https://doi.org/10.1056/NEJM197902153000702 Fefer et al. 1979]
| style="background-color:#ffffbe" |Pilot, <20 pts
+
| style="background-color:#ffffbe" |Pilot, fewer than 20 pts
 
|-
 
|-
 
|}
 
|}
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<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
*[[Busulfan (Myleran)]]
+
*[[Busulfan (Myleran)]] 5 mg/kg IV once on day -6
*[[Cyclophosphamide (Cytoxan)]]
+
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -5 & -4
 
====Radiotherapy====
 
====Radiotherapy====
*[[External beam radiotherapy|TBI]]
+
*[[External beam radiotherapy|TBI]] 920 rads on day 0
 
====Immunotherapy====
 
====Immunotherapy====
*[[Allogeneic stem cells]]
+
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="ab84cb" />
 
<section end="ab84cb" />
 
</div>
 
</div>
 
===References===
 
===References===
#Fefer A, Cheever MA, Thomas ED, Boyd C, Ramberg R, Glucksberg H, Buckner CD, Storb R. Disappearance of Ph1-positive cells in four patients with chronic granulocytic leukemia after chemotherapy, irradiation and marrow transplantation from an identical twin. N Engl J Med. 1979 Feb 15;300(7):333-7. [https://doi.org/10.1056/NEJM197902153000702 link to original article] [https://pubmed.ncbi.nlm.nih.gov/366408 PubMed]
+
#Fefer A, Cheever MA, Thomas ED, Boyd C, Ramberg R, Glucksberg H, Buckner CD, Storb R. Disappearance of Ph1-positive cells in four patients with chronic granulocytic leukemia after chemotherapy, irradiation and marrow transplantation from an identical twin. N Engl J Med. 1979 Feb 15;300(7):333-7. [https://doi.org/10.1056/NEJM197902153000702 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/366408/ PubMed]
 +
 
 
==Busulfan & Cyclophosphamide {{#subobject:83e07a|Regimen=1}}==
 
==Busulfan & Cyclophosphamide {{#subobject:83e07a|Regimen=1}}==
 
BuCy: '''<u>Bu</u>'''sulfan & '''<u>Cy</u>'''clophosphamide
 
BuCy: '''<u>Bu</u>'''sulfan & '''<u>Cy</u>'''clophosphamide
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #1, 9.6/120 {{#subobject:5a23a8|Variant=1}}===
+
===Regimen variant #1, 3.2 x 4/120 {{#subobject:eeaff3|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 100%; text-align:center;"
! style="width: 25%" |Study
+
!style="width: 17%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 15%"|Dates of enrollment
 +
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 17%"|Comparator
 +
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
!style="width: 17%"|[[Levels_of_Evidence#Efficacy|Non-relapse mortality]]
 
|-
 
|-
|[https://doi.org/10.1053/bbmt.2002.v8.pm11939604 Andersson et al. 2002]
+
|[https://doi.org/10.1200/JCO.2016.70.7349 Kröger et al. 2017 (RICMAC)]
| style="background-color:#91cf61" |Phase 2
+
|2004-2012
|-
+
| style="background-color:#1a9851" |Phase 3 (C)
|}
+
|[[Allogeneic_HSCT#Busulfan_.26_Fludarabine_2|Bu/Flu RIC allo HSCT]]
<section begin="5a23a8" />
+
| style="background-color:#fee08b" |Might have inferior OS
''Note: abstract is limited in detail including which days the treatments are given.''
+
|
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Busulfan (Myleran)]] 0.6 mg/kg IV every 6 hours for 16 doses (total dose: 9.6 mg/kg)
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day for 2 days (total dose: 120 mg/kg)
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on unspecified day
 
</div>
 
<section end="5a23a8" />
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #2, 12.8/120 {{#subobject:eeaff3|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Years of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
 
|-
 
|-
 
|[https://doi.org/10.1200/jco.2011.40.2362 Lee et al. 2013 (COSAH C-005)]
 
|[https://doi.org/10.1200/jco.2011.40.2362 Lee et al. 2013 (COSAH C-005)]
Line 84: Line 69:
 
| style="background-color:#1a9851" |Phase 3 (C)
 
| style="background-color:#1a9851" |Phase 3 (C)
 
|[[#Busulfan_.26_Fludarabine|Busulfan & Fludarabine]]
 
|[[#Busulfan_.26_Fludarabine|Busulfan & Fludarabine]]
| style="background-color:#91cf60" |Seems to have superior OS
+
| style="background-color:#91cf60" |Seems to have superior OS (secondary endpoint)
 +
|
 
|-
 
|-
 
|[https://doi.org/10.1016/S1470-2045(15)00200-4 Rambaldi et al. 2015 (GITMO-AMLR2)]
 
|[https://doi.org/10.1016/S1470-2045(15)00200-4 Rambaldi et al. 2015 (GITMO-AMLR2)]
Line 90: Line 76:
 
| style="background-color:#1a9851" |Phase 3 (C)
 
| style="background-color:#1a9851" |Phase 3 (C)
 
|[[#Busulfan_.26_Fludarabine|Busulfan & Fludarabine]]
 
|[[#Busulfan_.26_Fludarabine|Busulfan & Fludarabine]]
 +
|
 
| style="background-color:#fc8d59" |Seems to have inferior 1-year non-relapse mortality
 
| style="background-color:#fc8d59" |Seems to have inferior 1-year non-relapse mortality
 +
|-
 +
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839269/ Zhang et al. 2023]
 +
|2016-01 to 2020-02
 +
| style="background-color:#1a9851" |Phase 3 (E-switch-ooc)
 +
|[[#Cyclophosphamide_.26_TBI|TBI-Cy]]
 +
| style="background-color:#eeee01" |Non-inferior OS24 (primary endpoint)<br>OS24: 76.6% vs 79.4%
 +
| style="background-color:#ffffbf" |Similar NRM
 +
|-
 +
|[https://doi.org/10.1016/S2352-3026(22)00375-1 Xuan et al. 2023]
 +
|2016-04-18 to 2019-09-30
 +
| style="background-color:#1a9851" |Phase 3 (C)
 +
|[[#Busulfan.2C_Cyclophosphamide.2C_Decitabine.2C_G-CSF|Busulfan, Cyclophosphamide, Decitabine, G-CSF]]
 +
| style="background-color:#d73027" |Inferior CIR24
 +
|
 
|-
 
|-
 
|}
 
|}
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*[[Methotrexate (MTX)]] "according to the discretion of the attending physician"
 
*[[Methotrexate (MTX)]] "according to the discretion of the attending physician"
 
====Supportive therapy====
 
====Supportive therapy====
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC greater than 3000/uL
+
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC greater than 3000/μL
 +
'''One course'''
 
</div>
 
</div>
 
<section end="eeaff3" />
 
<section end="eeaff3" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #3, 16/200 {{#subobject:334af6|Variant=1}}===
+
===Regimen variant #2, 0.8 x 16/120 {{#subobject:ejug23|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 +
!style="width: 17%"|Study
 +
!style="width: 15%"|Dates of enrollment
 +
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 17%"|Comparator
 +
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
!style="width: 17%"|[[Levels_of_Evidence#Efficacy|Non-relapse mortality]]
 +
|-
 +
|[https://doi.org/10.1053/bbmt.2002.v8.pm11939604 Andersson et al. 2002]
 +
|1996-06 to 1997-12
 +
| style="background-color:#91cf61" |Phase 2
 +
|
 +
|
 +
|
 +
|-
 +
|[https://doi.org/10.1200/jco.23.00101 Ling et al. 2023]
 +
|2015-11-20 to 2019-09-30
 +
| style="background-color:#1a9851" |Phase 3 (C)
 +
|[[#Busulfan_.26_Fludarabine|BuFlu]]
 +
|
 +
| style="background-color:#fc8d59" |Seems to have inferior TRM12
 +
|-
 +
|}
 +
<section begin="ejug23" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Busulfan (Myleran)]] 0.8 mg/kg IV four times per per day on days -7 to -4 (total dose: 12.8 mg/kg)
 +
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -3 and -2 (total dose: 120 mg/kg)
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 +
</div>
 +
<section end="ejug23" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #3, 1 x 16/200 {{#subobject:334af6|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |Study
Line 126: Line 164:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on unspecified day
 
*[[Allogeneic stem cells]] transfused on unspecified day
 +
'''One course'''
 
</div>
 
</div>
 
<section end="334af6" />
 
<section end="334af6" />
 
</div>
 
</div>
 
===References===
 
===References===
#Santos GW, Tutschka PJ, Brookmeyer R, Saral R, Beschorner WE, Bias WB, Braine HG, Burns WH, Elfenbein GJ, Kaizer H, Mellits D, Sensenbrenner LL, Stuart RK, Yeager AM. Marrow transplantation for acute nonlymphocytic leukemia after treatment with busulfan and cyclophosphamide. N Engl J Med. 1983 Dec 1;309(22):1347-53. [https://doi.org/10.1056/NEJM198312013092202 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/6355849 PubMed]
+
#Santos GW, Tutschka PJ, Brookmeyer R, Saral R, Beschorner WE, Bias WB, Braine HG, Burns WH, Elfenbein GJ, Kaizer H, Mellits D, Sensenbrenner LL, Stuart RK, Yeager AM. Marrow transplantation for acute nonlymphocytic leukemia after treatment with busulfan and cyclophosphamide. N Engl J Med. 1983 Dec 1;309(22):1347-53. [https://doi.org/10.1056/NEJM198312013092202 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/6355849/ PubMed]
#Andersson BS, Kashyap A, Gian V, Wingard JR, Fernandez H, Cagnoni PJ, Jones RB, Tarantolo S, Hu WW, Blume KG, Forman SJ, Champlin RE. Conditioning therapy with intravenous busulfan and cyclophosphamide (IV BuCy2) for hematologic malignancies prior to allogeneic stem cell transplantation: a phase II study. Biol Blood Marrow Transplant. 2002;8(3):145-54. [https://doi.org/10.1053/bbmt.2002.v8.pm11939604 link to original article] '''contains partial protocol''' [https://pubmed.ncbi.nlm.nih.gov/11939604 PubMed]
+
#Andersson BS, Kashyap A, Gian V, Wingard JR, Fernandez H, Cagnoni PJ, Jones RB, Tarantolo S, Hu WW, Blume KG, Forman SJ, Champlin RE. Conditioning therapy with intravenous busulfan and cyclophosphamide (IV BuCy2) for hematologic malignancies prior to allogeneic stem cell transplantation: a phase II study. Biol Blood Marrow Transplant. 2002;8(3):145-54. [https://doi.org/10.1053/bbmt.2002.v8.pm11939604 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/11939604/ PubMed]
#'''COSAH C-005:''' Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. Epub 2012 Nov 5. [https://doi.org/10.1200/jco.2011.40.2362 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23129746 PubMed] NCT00774280
+
#'''COSAH C-005:''' Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. Epub 2012 Nov 5. [https://doi.org/10.1200/jco.2011.40.2362 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23129746/ PubMed] [https://clinicaltrials.gov/study/NCT00774280 NCT00774280]
#'''GITMO-AMLR2:''' Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. [https://doi.org/10.1016/S1470-2045(15)00200-4 link to original article] [https://pubmed.ncbi.nlm.nih.gov/26429297 PubMed] NCT01191957
+
#'''GITMO-AMLR2:''' Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. [https://doi.org/10.1016/S1470-2045(15)00200-4 link to original article] [https://pubmed.ncbi.nlm.nih.gov/26429297/ PubMed] [https://clinicaltrials.gov/study/NCT01191957 NCT01191957]
==Busulfan & Fludarabine {{#subobject:576283|Regimen=1}}==
+
# '''RICMAC:''' Kröger N, Iacobelli S, Franke GN, Platzbecker U, Uddin R, Hübel K, Scheid C, Weber T, Robin M, Stelljes M, Afanasyev B, Heim D, Deliliers GL, Onida F, Dreger P, Pini M, Guidi S, Volin L, Günther A, Bethge W, Poiré X, Kobbe G, van Os M, Brand R, de Witte T. Dose-Reduced Versus Standard Conditioning Followed by Allogeneic Stem-Cell Transplantation for Patients With Myelodysplastic Syndrome: A Prospective Randomized Phase III Study of the EBMT (RICMAC Trial). J Clin Oncol. 2017 Jul 1;35(19):2157-2164. Epub 2017 May 2. [https://doi.org/10.1200/JCO.2016.70.7349 link to original article] [https://pubmed.ncbi.nlm.nih.gov/28463633/ PubMed] [https://clinicaltrials.gov/study/NCT01203228 NCT01203228]
BuFlu: '''<u>Bu</u>'''sulfan & '''<u>Flu</u>'''darabine
+
#Zhang H, Fan Z, Huang F, Han L, Xu Y, Xu N, Deng L, Wang S, Lin D, Luo X, Zhang Q, Liu X, Li X, Liang X, Xie S, Qu H, Yu S, Zhou H, Shi P, Xuan L, Lin R, Liu H, Jin H, Sun J, Liu Q. Busulfan Plus Cyclophosphamide Versus Total Body Irradiation Plus Cyclophosphamide for Adults Acute B Lymphoblastic Leukemia: An Open-Label, Multicenter, Phase III Trial. J Clin Oncol. 2023 Jan 10;41(2):343-353. Epub 2022 Sep 9. [https://doi.org/10.1200/JCO.22.00767 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839269/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/36084276/ PubMed] [https://clinicaltrials.gov/study/NCT02670252 NCT02670252]
<br>Flu/Bu: '''<u>Flu</u>'''darabine & '''<u>Bu</u>'''sulfan
+
#Xuan L, Dai M, Jiang E, Wang Y, Huang F, Fan Z, Xu N, Nie D, Liang X, Chen H, Ye J, Shi P, Liu H, Jin H, Lin R, Yan C, Zhang Y, Sun J, Han M, Liu Q. The effect of granulocyte-colony stimulating factor, decitabine, and busulfan-cyclophosphamide versus busulfan-cyclophosphamide conditioning on relapse in patients with myelodysplastic syndrome or secondary acute myeloid leukaemia evolving from myelodysplastic syndrome undergoing allogeneic haematopoietic stem-cell transplantation: an open-label, multicentre, randomised, phase 3 trial. Lancet Haematol. 2023 Mar;10(3):e178-e190. Epub 2023 Jan 23. [https://doi.org/10.1016/S2352-3026(22)00375-1 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/36702138/ PubMed] [https://clinicaltrials.gov/study/NCT02744742 NCT02744742]
 +
#Ling Y, Xuan L, Xu N, Huang F, Fan Z, Guo Z, Xu X, Liu H, Lin R, Yu S, Zhang H, Jin H, Wu M, Liu C, Liang X, Ou R, Zhang Y, Liu X, Qu H, Zhai X, Sun J, Zhao Y, Liu Q. Busulfan Plus Fludarabine Compared With Busulfan Plus Cyclophosphamide for AML Undergoing HLA-Haploidentical Hematopoietic Cell Transplantation: A Multicenter Randomized Phase III Trial. J Clin Oncol. 2023 Oct 10;41(29):4632-4642. Epub 2023 Jun 19. [https://doi.org/10.1200/jco.23.00101 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/37335960/ PubMed] [https://clinicaltrials.gov/study/NCT02487069 NCT02487069]
 +
 
 +
==Busulfan, Cyclophosphamide, Decitabine, G-CSF {{#subobject:4ye07a|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #1 {{#subobject:d415a|Variant=1}}===
+
===Regimen {{#subobject:57gch8|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
 +
|[https://doi.org/10.1016/S2352-3026(22)00375-1 Xuan et al. 2023]
 +
|2016-04-18 to 2019-09-30
 +
| style="background-color:#1a9851" |Phase 3 (E-esc)
 +
|[[#Busulfan_.26_Cyclophosphamide|BuCy]]
 +
| style="background-color:#1a9850" |Superior CIR24 (primary endpoint)<br>CIR24: 10.9% vs 24.8%<br>(HR 0.39, 95% CI 0.19-0.79)
 +
|-
 +
|}
 +
<section begin="57gch8" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Busulfan (Myleran)]] 3.2 mg/kg IV once per day on days -7 to -4 (total dose: 12.8 mg/kg)
 +
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -3 & -2 (total dose: 120 mg/kg)
 +
*[[Decitabine (Dacogen)]] 20 mg/m<sup>2</sup> IV once per day on days -14 to -10
 +
====Growth factor therapy====
 +
*[[:Category:Granulocyte colony-stimulating factors|G-CSF]] 5 mcg/kg once per day on days -17 to -10
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 +
</div>
 +
<section end="57gch8" />
 +
</div>
 +
===References===
 +
#Xuan L, Dai M, Jiang E, Wang Y, Huang F, Fan Z, Xu N, Nie D, Liang X, Chen H, Ye J, Shi P, Liu H, Jin H, Lin R, Yan C, Zhang Y, Sun J, Han M, Liu Q. The effect of granulocyte-colony stimulating factor, decitabine, and busulfan-cyclophosphamide versus busulfan-cyclophosphamide conditioning on relapse in patients with myelodysplastic syndrome or secondary acute myeloid leukaemia evolving from myelodysplastic syndrome undergoing allogeneic haematopoietic stem-cell transplantation: an open-label, multicentre, randomised, phase 3 trial. Lancet Haematol. 2023 Mar;10(3):e178-e190. Epub 2023 Jan 23. [https://doi.org/10.1016/S2352-3026(22)00375-1 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/36702138/ PubMed] [https://clinicaltrials.gov/study/NCT02744742 NCT02744742]
 +
 +
==Busulfan & Fludarabine {{#subobject:576283|Regimen=1}}==
 +
BuFlu: '''<u>Bu</u>'''sulfan & '''<u>Flu</u>'''darabine
 +
<br>Flu/Bu: '''<u>Flu</u>'''darabine & '''<u>Bu</u>'''sulfan
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #1 {{#subobject:d41ng5|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 +
!style="width: 17%"|Study
 +
!style="width: 15%"|Dates of enrollment
 +
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 17%"|Comparator
 +
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
 +
|-
 +
|[https://doi.org/10.1200/jco.23.00101 Ling et al. 2023]
 +
|2015-11-20 to 2019-09-30
 +
| style="background-color:#1a9851" |Phase 3 (E-de-esc)
 +
|[[#Busulfan_.26_Cyclophosphamide|Busulfan & Cyclophosphamide]]
 +
|
 +
| style="background-color:#91cf60" |Seems to have superior TRMM12 (primary endpoint)
 +
|-
 +
|}
 +
'''Diseases Studied: [[Acute myeloid leukemia]]'''
 +
<section begin="d41ng5" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Busulfan (Myleran)]] 0.8 mg/kg IV four times per day for 2 hour infusions on days -6 to -3
 +
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -7 to -3
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 +
</div>
 +
<section end="d41ng5" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #2 {{#subobject:d415a|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 +
!style="width: 17%"|Study
 +
!style="width: 15%"|Dates of enrollment
 +
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 17%"|Comparator
 +
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
 
|-
 
|-
 
|[https://doi.org/10.1016/S1470-2045(15)00200-4 Rambaldi et al. 2015 (GITMO-AMLR2)]
 
|[https://doi.org/10.1016/S1470-2045(15)00200-4 Rambaldi et al. 2015 (GITMO-AMLR2)]
Line 151: Line 259:
 
| style="background-color:#1a9851" |Phase 3 (E-switch-ic)
 
| style="background-color:#1a9851" |Phase 3 (E-switch-ic)
 
|[[#Busulfan_.26_Cyclophosphamide|Busulfan & Cyclophosphamide]]
 
|[[#Busulfan_.26_Cyclophosphamide|Busulfan & Cyclophosphamide]]
| style="background-color:#fc8d59" |Seems to improve 1 & 2 year NRM, similar OS
+
|
 +
| style="background-color:#91cf60" |Seems to have superior NRM12 (primary endpoint)
 
|-
 
|-
 
|}
 
|}
'''Diseases Studied: [[Acute myeloid leukemia]]'''
+
'''Diseases Studied: [[Acute myeloid leukemia]]'''<br>
 
'''Graft types studied''': Bone Marrow, Mobilized Peripheral Blood Stem Cells
 
'''Graft types studied''': Bone Marrow, Mobilized Peripheral Blood Stem Cells
 
<section begin="d415a" />
 
<section begin="d415a" />
Line 161: Line 270:
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV four times per day for 2 hour infusions on days -6 to -3
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV four times per day for 2 hour infusions on days -6 to -3
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -3
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -3
====Immunosuppressive therapy====
+
====GVHD prophylaxis, pre-transplant====
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] by the following criteria:
+
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] by the following donor-based criteria:
**Unrelated donors, identical: 0.5 mg/kg IV once on day -3, then 2 mg/kg IV once on day -2, then 2.5 mg/kg IV once on day -1
+
**Matched unrelated donors: 0.5 mg/kg IV once on day -3, then 2 mg/kg IV once on day -2, then 2.5 mg/kg IV once on day -1
**If donor mismatched total ATG dose could be increased to 7.5 mg/kg
+
**Mismatched donors: total ATG dose could be increased to 7.5 mg/kg
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
====GVHD prophylaxis====
+
====GVHD prophylaxis, post-transplant====
 
*[[Cyclosporine]]
 
*[[Cyclosporine]]
 
*[[Methotrexate (MTX)]]
 
*[[Methotrexate (MTX)]]
 +
'''One course'''
 
</div>
 
</div>
 
<section end="d415a" />
 
<section end="d415a" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #2 {{#subobject:d415b|Variant=1}}===
+
 
 +
===Regimen variant #3 {{#subobject:d415b|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
Line 198: Line 309:
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
| style="background-color:#d3d3d3" |
+
| style="background-color:#d3d3d3" |-
 
|}
 
|}
'''Diseases Studied: [[Acute myeloid leukemia]], [[Myelodysplastic syndrome]], [[Acute lymphocytic leukemia]], [[Chronic myeloid leukemia]], [[Non-Hodgkin lymphoma]]'''
+
'''Diseases Studied: [[Acute myeloid leukemia]], [[Myelodysplastic syndrome]], [[Acute lymphocytic leukemia]], [[Chronic myeloid leukemia]], [[Non-Hodgkin lymphoma]]'''<br>
 
'''Graft types studied''': Matched Related / Unrelated Donor Bone Marrow, Mobilized Peripheral Blood Stem Cells
 
'''Graft types studied''': Matched Related / Unrelated Donor Bone Marrow, Mobilized Peripheral Blood Stem Cells
 
<section begin="d415b" />
 
<section begin="d415b" />
Line 208: Line 319:
 
**Dosing targeted for optimal pharmacokinetics but different parameters each institution, please consult the original publication for optimal levels
 
**Dosing targeted for optimal pharmacokinetics but different parameters each institution, please consult the original publication for optimal levels
 
*[[Fludarabine (Fludara)]] 40 mg/m<sup>2</sup> IV over 60 minutes once per day on days -6 to -3, '''given first'''
 
*[[Fludarabine (Fludara)]] 40 mg/m<sup>2</sup> IV over 60 minutes once per day on days -6 to -3, '''given first'''
====Immunosuppressive therapy====
+
====GVHD prophylaxis, pre-transplant====
*''For unrelated or mismatched donors'': [[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 0.5 mg/kg IV once on day -3, then 1.5 mg/kg IV once on day -2, then 2 mg/kg IV once on day -1
+
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] by the following donor-based criteria:
 +
**Unrelated or mismatched donors: 0.5 mg/kg IV once on day -3, then 1.5 mg/kg IV once on day -2, then 2 mg/kg IV once on day -1
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
====GVHD prophylaxis====
+
====GVHD prophylaxis, post-transplant====
 
<nowiki>#</nowiki>1 Tacrolimus & methotrexate based (Andersson et al.)
 
<nowiki>#</nowiki>1 Tacrolimus & methotrexate based (Andersson et al.)
 
*[[Tacrolimus (Prograf)]]
 
*[[Tacrolimus (Prograf)]]
 
*[[Methotrexate (MTX)]]
 
*[[Methotrexate (MTX)]]
 
====Supportive therapy====
 
====Supportive therapy====
*All patients received [[Filgrastim (Neupogen)]] SC once per day from day +7 until achieving an absolute neutrophil count (ANC) ≥1.5 × 10<sup>9</sup>/L for three days
+
*All patients received [[Filgrastim (Neupogen)]] SC once per day from day +7 until achieving an absolute neutrophil count (ANC) ≥1.5 x 10<sup>9</sup>/L for three days
 
*[[Phenytoin (Dilantin)]] prophylaxis used during and for one day after IV busulfan
 
*[[Phenytoin (Dilantin)]] prophylaxis used during and for one day after IV busulfan
 
<nowiki>#</nowiki>2 Post-Transplant Cy based (Kanakry et al. and FHCC 2541.00)
 
<nowiki>#</nowiki>2 Post-Transplant Cy based (Kanakry et al. and FHCC 2541.00)
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once per day on days +3 & +4 (used alone in Kanakry et al. when all patients received bone marrow grafts)
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once per day on days +3 & +4 (used alone in Kanakry et al. when all patients received bone marrow grafts)
*± [[Cyclosporine]] intravenous loading dose of CSP was given on day 5, followed by subsequent twice daily dosing adjusted to maintain whole blood trough at 120 to 360 ng/mL. In abscence of GVHD Cyclosporine was tapered from day +56 through day +126 (used in FHCC 2541.00 with PBSCT grafts)
+
*± [[Cyclosporine]] intravenous loading dose of CSP was given on day 5, followed by subsequent twice per day dosing adjusted to maintain whole blood trough at 120 to 360 ng/mL. In abscence of GVHD Cyclosporine was tapered from day +56 through day +126 (used in FHCC 2541.00 with PBSCT grafts)
 
====Supportive therapy====
 
====Supportive therapy====
 
*[[Mesna (Mesnex)]] given with cyclophosphamide
 
*[[Mesna (Mesnex)]] given with cyclophosphamide
 +
'''One course'''
 
</div>
 
</div>
 
<section end="d415b" />
 
<section end="d415b" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #3 {{#subobject:d415c|Variant=1}}===
+
===Regimen variant #4 {{#subobject:d415c|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
Line 241: Line 354:
 
| style="background-color:#1a9851" |Phase 3 (E-switch-ic)
 
| style="background-color:#1a9851" |Phase 3 (E-switch-ic)
 
|[[#Busulfan_.26_Cyclophosphamide|Busulfan & Cyclophosphamide]]
 
|[[#Busulfan_.26_Cyclophosphamide|Busulfan & Cyclophosphamide]]
| style="background-color:#fc8d59" |Seems to have inferior OS
+
| style="background-color:#fc8d59" |Seems to have inferior OS (secondary endpoint)
 
|-
 
|-
 
|}
 
|}
'''Diseases Studied: [[Acute myeloid leukemia]], [[Myelodysplastic syndrome]], [[Acute lymphocytic leukemia]], [[Chronic myeloid leukemia]], [[Myelofibrosis]]'''
+
'''Diseases Studied: [[Acute myeloid leukemia]], [[Myelodysplastic syndrome]], [[Acute lymphocytic leukemia]], [[Chronic myeloid leukemia]], [[Myelofibrosis]]'''<br>
 
'''Graft types studied''': Matched Related / Unrelated Donor Bone Marrow, Mobilized Peripheral Blood Stem Cells
 
'''Graft types studied''': Matched Related / Unrelated Donor Bone Marrow, Mobilized Peripheral Blood Stem Cells
 
<section begin="d415c" />
 
<section begin="d415c" />
Line 257: Line 370:
 
*[[Methotrexate (MTX)]] "according to the discretion of the attending physician"
 
*[[Methotrexate (MTX)]] "according to the discretion of the attending physician"
 
====Supportive therapy====
 
====Supportive therapy====
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC greater than 3000/uL
+
*[[Filgrastim (Neupogen)]] 450 mcg SC once per day, starting on day +5 and continued until ANC greater than 3000/μL
 +
'''One course'''
 
</div>
 
</div>
 
<section end="d415c" />
 
<section end="d415c" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #4 {{#subobject:6eb66d|Variant=1}}===
+
===Regimen variant #5 {{#subobject:6eb66d|Variant=1}}===
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
!style="width: 33%"|Study
 
!style="width: 33%"|Study
!style="width: 33%"|Years of enrollment
+
!style="width: 33%"|Dates of enrollment
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
Line 273: Line 387:
 
|-
 
|-
 
|}
 
|}
'''Diseases Studied: [[Acute myeloid leukemia]], [[Myelodysplastic syndrome]], [[Chronic myeloid leukemia]], [[Chronic lymphocytic leukemia]], [[Non-Hodgkin lymphoma]], [[Hypereosinophilic syndrome]]'''
+
'''Diseases Studied: [[Acute myeloid leukemia]], [[Myelodysplastic syndrome]], [[Chronic myeloid leukemia]], [[Chronic lymphocytic leukemia]], [[Non-Hodgkin lymphoma]], [[Hypereosinophilic syndrome]]'''<br>
 
'''Graft types studied''': Matched Related / Unrelated Donor Bone Marrow or Mobilized Peripheral Blood Stem Cells
 
'''Graft types studied''': Matched Related / Unrelated Donor Bone Marrow or Mobilized Peripheral Blood Stem Cells
 
<section begin="6eb66d" />
 
<section begin="6eb66d" />
Line 280: Line 394:
 
*[[Busulfan (Myleran)]] 3.2 mg/kg (ideal body weight) IV over 3 hours once per day on days -5 to -2
 
*[[Busulfan (Myleran)]] 3.2 mg/kg (ideal body weight) IV over 3 hours once per day on days -5 to -2
 
*[[Fludarabine (Fludara)]] 50 mg/m<sup>2</sup> IV once per day on days -6 to -2
 
*[[Fludarabine (Fludara)]] 50 mg/m<sup>2</sup> IV once per day on days -6 to -2
====Immunosuppressive therapy====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 0.5 mg/kg IV once on day -2, then 2 mg/kg IV once per day on days -1 & 0 (total dose of 4.5 mg/kg)
 
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 0.5 mg/kg IV once on day -2, then 2 mg/kg IV once per day on days -1 & 0 (total dose of 4.5 mg/kg)
 
*[[Cyclosporine]] IV or PO twice per day, with doses adjusted to maintain cyclosporine levels of 150 to 400 umol/L
 
*[[Cyclosporine]] IV or PO twice per day, with doses adjusted to maintain cyclosporine levels of 150 to 400 umol/L
*[[Methotrexate (MTX)]] 15 mg/m<sup>2</sup> (route not specified) once on day 1, then 10 mg/m<sup>2</sup> (route not specified) once per day on days 3, 6, 11
+
*[[Methotrexate (MTX)]] 15 mg/m<sup>2</sup> (route not specified) once on day 1, then 10 mg/m<sup>2</sup> (route not specified) once per day on days +3, +6, +11
 
====Supportive therapy====
 
====Supportive therapy====
*[[Folinic acid (Leucovorin)]] 5 mg started 24 hours after each dose of methotrexate and continued every 6 hours until 12 hours before the next dose of methotrexate
+
*[[Leucovorin (Folinic acid)]] 5 mg started 24 hours after each dose of methotrexate and continued every 6 hours until 12 hours before the next dose of methotrexate
 
*[[Phenytoin (Dilantin)]] "loading" PO/IV, dosed to maintain therapeutic levels of 40 to 80 umol/L on days -5 to -2
 
*[[Phenytoin (Dilantin)]] "loading" PO/IV, dosed to maintain therapeutic levels of 40 to 80 umol/L on days -5 to -2
 +
'''One course'''
 
</div>
 
</div>
 
<section end="6eb66d" />
 
<section end="6eb66d" />
 
</div>
 
</div>
 
===References===
 
===References===
#Russell JA, Tran HT, Quinlan D, Chaudhry A, Duggan P, Brown C, Stewart D, Ruether JD, Morris D, Glick S, Gyonyor E, Andersson BS. Once-daily intravenous busulfan given with fludarabine as conditioning for allogeneic stem cell transplantation: study of pharmacokinetics and early clinical outcomes. Biol Blood Marrow Transplant. 2002;8(9):468-76. [https://doi.org/10.1053/bbmt.2002.v8.pm12374451 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12374451 PubMed]
+
#Russell JA, Tran HT, Quinlan D, Chaudhry A, Duggan P, Brown C, Stewart D, Ruether JD, Morris D, Glick S, Gyonyor E, Andersson BS. Once-daily intravenous busulfan given with fludarabine as conditioning for allogeneic stem cell transplantation: study of pharmacokinetics and early clinical outcomes. Biol Blood Marrow Transplant. 2002;8(9):468-76. [https://doi.org/10.1053/bbmt.2002.v8.pm12374451 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12374451/ PubMed]
 
#de Lima M, Couriel D, Thall PF, Wang X, Madden T, Jones R, Shpall EJ, Shahjahan M, Pierre B, Giralt S, Korbling M, Russell JA, Champlin RE, Andersson BS. Once-daily intravenous busulfan and fludarabine: clinical and pharmacokinetic results of a myeloablative, reduced-toxicity conditioning regimen for allogeneic stem cell transplantation in AML and MDS. Blood. 2004 Aug 1;104(3):857-64. Epub 2004 Apr 8. [https://doi.org/10.1182/blood-2004-02-0414 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15073038/ PubMed]
 
#de Lima M, Couriel D, Thall PF, Wang X, Madden T, Jones R, Shpall EJ, Shahjahan M, Pierre B, Giralt S, Korbling M, Russell JA, Champlin RE, Andersson BS. Once-daily intravenous busulfan and fludarabine: clinical and pharmacokinetic results of a myeloablative, reduced-toxicity conditioning regimen for allogeneic stem cell transplantation in AML and MDS. Blood. 2004 Aug 1;104(3):857-64. Epub 2004 Apr 8. [https://doi.org/10.1182/blood-2004-02-0414 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15073038/ PubMed]
#Andersson BS, de Lima M, Thall PF, Wang X, Couriel D, Korbling M, Roberson S, Giralt S, Pierre B, Russell JA, Shpall EJ, Jones RB, Champlin RE. Once daily IV busulfan and fludarabine (IV Bu-Flu) compares favorably with IV busulfan and cyclophosphamide (IV BuCy2) as pretransplant conditioning therapy in AML/MDS. Biol Blood Marrow Transplant. 2008;14(6):672-84. [https://doi.org/10.1016/j.bbmt.2008.03.009 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230823/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18489993 Pubmed]
+
#Andersson BS, de Lima M, Thall PF, Wang X, Couriel D, Korbling M, Roberson S, Giralt S, Pierre B, Russell JA, Shpall EJ, Jones RB, Champlin RE. Once daily IV busulfan and fludarabine (IV Bu-Flu) compares favorably with IV busulfan and cyclophosphamide (IV BuCy2) as pretransplant conditioning therapy in AML/MDS. Biol Blood Marrow Transplant. 2008;14(6):672-84. [https://doi.org/10.1016/j.bbmt.2008.03.009 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230823/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18489993/ PubMed]
#'''COSAH C-005:''' Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. Epub 2012 Nov 5. [https://doi.org/10.1200/jco.2011.40.2362 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23129746 PubMed] NCT00774280
+
#'''COSAH C-005:''' Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. Epub 2012 Nov 5. [https://doi.org/10.1200/jco.2011.40.2362 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23129746/ PubMed] [https://clinicaltrials.gov/study/NCT00774280 NCT00774280]
#'''J0844:''' Kanakry CG, O'Donnell PV, Furlong T, de Lima MJ, Wei W, Medeot M, Mielcarek M, Champlin RE, Jones RJ, Thall PF, Andersson BS, Luznik L. Multi-institutional study of post-transplantation cyclophosphamide as single-agent graft-versus-host disease prophylaxis after allogeneic bone marrow transplantation using myeloablative busulfan and fludarabine conditioning. J Clin Oncol. 2014; 32(31):3497-505. Epub 2014 Sep 29. [https://doi.org/10.1200/JCO.2013.54.0625 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209101/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25267759 Pubmed] NCT00809276
+
#'''J0844:''' Kanakry CG, O'Donnell PV, Furlong T, de Lima MJ, Wei W, Medeot M, Mielcarek M, Champlin RE, Jones RJ, Thall PF, Andersson BS, Luznik L. Multi-institutional study of post-transplantation cyclophosphamide as single-agent graft-versus-host disease prophylaxis after allogeneic bone marrow transplantation using myeloablative busulfan and fludarabine conditioning. J Clin Oncol. 2014; 32(31):3497-505. Epub 2014 Sep 29. [https://doi.org/10.1200/JCO.2013.54.0625 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209101/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25267759/ PubMed] [https://clinicaltrials.gov/study/NCT00809276 NCT00809276]
#'''FHCC 2541.00:''' Mielcarek M, Furlong T, O'Donnell PV, Storer BE, McCune JS, Storb R, Carpenter PA, Flowers ME, Appelbaum FR, Martin PJ. Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation. Blood. 2016;127(11):1502-8. [http://www.bloodjournal.org/content/127/11/1502.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4797026/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26764356 Pubmed] NCT01427881
+
#'''FHCC 2541.00:''' Mielcarek M, Furlong T, O'Donnell PV, Storer BE, McCune JS, Storb R, Carpenter PA, Flowers ME, Appelbaum FR, Martin PJ. Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation. Blood. 2016;127(11):1502-8. Epub 2016 Jan 13. [https://doi.org/10.1182/blood-2015-10-672071 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4797026/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26764356/ PubMed] [https://clinicaltrials.gov/study/NCT01427881 NCT01427881]
#'''GITMO-AMLR2:''' Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. [https://doi.org/10.1016/S1470-2045(15)00200-4 link to original article] [https://pubmed.ncbi.nlm.nih.gov/26429297 PubMed] NCT01191957
+
#'''GITMO-AMLR2:''' Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. [https://doi.org/10.1016/S1470-2045(15)00200-4 link to original article] [https://pubmed.ncbi.nlm.nih.gov/26429297/ PubMed] [https://clinicaltrials.gov/study/NCT01191957 NCT01191957]
#'''MDACC 2011-0628:''' Andersson BS, Thall PF, Ma J, Valdez BC, Bassett R Jr, Chen J, Ahmed S, Alousi A, Bashir Q, Ciurea S, Gulbis A, Cool R, Kawedia J, Hosing C, Kebriaei P, Kornblau S, Myers A, Oran B, Rezvani K, Shah N, Shpall E, Parmar S, Popat UR, Nieto Y, Champlin RE. A randomized phase III study of pretransplant conditioning for AML/MDS with fludarabine and once daily IV busulfan ± clofarabine in allogeneic stem cell transplantation. Bone Marrow Transplant. 2022 Aug;57(8):1295-1303. Epub 2022 May 24. [https://doi.org/10.1038/s41409-022-01705-7 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc9352570/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/35610308/ PubMed] NCT01471444
+
#'''MDACC 2011-0628:''' Andersson BS, Thall PF, Ma J, Valdez BC, Bassett R Jr, Chen J, Ahmed S, Alousi A, Bashir Q, Ciurea S, Gulbis A, Cool R, Kawedia J, Hosing C, Kebriaei P, Kornblau S, Myers A, Oran B, Rezvani K, Shah N, Shpall E, Parmar S, Popat UR, Nieto Y, Champlin RE. A randomized phase III study of pretransplant conditioning for AML/MDS with fludarabine and once daily IV busulfan ± clofarabine in allogeneic stem cell transplantation. Bone Marrow Transplant. 2022 Aug;57(8):1295-1303. Epub 2022 May 24. [https://doi.org/10.1038/s41409-022-01705-7 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc9352570/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/35610308/ PubMed] [https://clinicaltrials.gov/study/NCT01471444 NCT01471444]
 +
#Ling Y, Xuan L, Xu N, Huang F, Fan Z, Guo Z, Xu X, Liu H, Lin R, Yu S, Zhang H, Jin H, Wu M, Liu C, Liang X, Ou R, Zhang Y, Liu X, Qu H, Zhai X, Sun J, Zhao Y, Liu Q. Busulfan Plus Fludarabine Compared With Busulfan Plus Cyclophosphamide for AML Undergoing HLA-Haploidentical Hematopoietic Cell Transplantation: A Multicenter Randomized Phase III Trial. J Clin Oncol. 2023 Oct 10;41(29):4632-4642. Epub 2023 Jun 19. [https://doi.org/10.1200/jco.23.00101 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/37335960/ PubMed] [https://clinicaltrials.gov/study/NCT02487069 NCT02487069]
 +
 
 
==Cyclophosphamide & TBI {{#subobject:a9f7e8|Regimen=1}}==
 
==Cyclophosphamide & TBI {{#subobject:a9f7e8|Regimen=1}}==
 
Cy/TBI: '''<u>Cy</u>'''clophosphamide & '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
 
Cy/TBI: '''<u>Cy</u>'''clophosphamide & '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
 +
<br>TBI-CY: '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation & '''<u>Cy</u>'''clophosphamide
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:6ca28d|Variant=1}}===
 
===Regimen {{#subobject:6ca28d|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 17%"|Study
 
!style="width: 17%"|Study
!style="width: 15%"|Years of enrollment
+
!style="width: 15%"|Dates of enrollment
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|Comparator
 
!style="width: 17%"|Comparator
Line 323: Line 440:
 
|[https://doi.org/10.1056/NEJM198201143060202 Fefer et al. 1982]
 
|[https://doi.org/10.1056/NEJM198201143060202 Fefer et al. 1982]
 
|1971-1980
 
|1971-1980
| style="background-color:#ffffbe" |Non-randomized, <20 pts
+
| style="background-color:#ffffbe" |Non-randomized, fewer than 20 pts
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
|-
 
|-
|[http://www.bloodjournal.org/content/54/2/468.long Thomas et al. 1979]
+
|[https://doi.org/10.1182/blood.V54.2.468.468 Thomas et al. 1979]
 
|1976-1977
 
|1976-1977
 
| style="background-color:#91cf61" |Non-randomized
 
| style="background-color:#91cf61" |Non-randomized
Line 337: Line 454:
 
|[https://doi.org/10.1056/NEJM198005083021901 Blume et al. 1980]
 
|[https://doi.org/10.1056/NEJM198005083021901 Blume et al. 1980]
 
|1976-1979
 
|1976-1979
| style="background-color:#ffffbe" |Non-randomized, <20 pts
+
| style="background-color:#ffffbe" |Non-randomized, fewer than 20 pts
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
Line 381: Line 498:
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
|Chemotherapy or Auto HSCT
 
|Chemotherapy or Auto HSCT
| style="background-color:#ffffbf" |Did not meet primary endpoints of DFS/OS
+
| style="background-color:#ffffbf" |Did not meet co-primary endpoints of DFS/OS
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
|-
 
|-
Line 393: Line 510:
 
|[https://doi.org/10.1200/jco.2004.10.050 Thomas et al. 2004 (LALA-94)]
 
|[https://doi.org/10.1200/jco.2004.10.050 Thomas et al. 2004 (LALA-94)]
 
|1994-2002
 
|1994-2002
| style="background-color:#91cf61" |Non-randomized portion of RCT
+
| style="background-color:#91cf61" |Non-randomized part of RCT
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
Line 404: Line 521:
 
|
 
|
 
| style="background-color:#ffffbf" |Did not meet primary endpoint of NRM
 
| style="background-color:#ffffbf" |Did not meet primary endpoint of NRM
 +
|-
 +
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839269/ Zhang et al. 2023]
 +
|2016-01 to 2020-02
 +
| style="background-color:#1a9851" |Phase 3 (C)
 +
|[[#Busulfan_.26_Cyclophosphamide|BuCy]]
 +
| style="background-color:#eeee01" |Non-inferior OS24
 +
| style="background-color:#ffffbf" |Similar NRM
 
|-
 
|-
 
|}
 
|}
 
<section begin="6ca28d" />
 
<section begin="6ca28d" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
''Details in the manuscripts are limited.''
+
''Details in most of the manuscripts are limited.''
 
====Chemotherapy====
 
====Chemotherapy====
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on two consecutive days
+
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -3 & -2
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation]], 10 to 12 Gy total
+
*[[External_beam_radiotherapy|Total body irradiation]] by the following study-specific criteria:
 +
**Zhang et al. 2023: 450 cGy once per day on days -5 & -4 (900 cGy total)
 +
**Other studies: 10 to 1200 cGy total
 
====Immunotherapy====
 
====Immunotherapy====
*[[Allogeneic stem cells]] transfused on unspecified day
+
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="6ca28d" />
 
<section end="6ca28d" />
 
</div>
 
</div>
 +
 
===References===
 
===References===
#Rudolph RH, Fefer A, Thomas ED, Buckner CD, Clift RA, Storb R. Isogeneic marrow grafts for hematologic malignancy in man. Arch Intern Med. 1973 Aug;132(2):279-85. [https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/581686 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4268940 PubMed]
+
#Rudolph RH, Fefer A, Thomas ED, Buckner CD, Clift RA, Storb R. Isogeneic marrow grafts for hematologic malignancy in man. Arch Intern Med. 1973 Aug;132(2):279-85. [https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/581686 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4268940/ PubMed]
##'''Update:''' Fefer A, Einstein AB, Thomas ED, Buckner CD, Clift RA, Glucksberg H, Neiman PE, Storb R. Bone-marrow transplantation for hematologic neoplasia in 16 patients with identical twins. N Engl J Med. 1974 Jun 20;290(25):1389-93. [https://doi.org/10.1056/NEJM197406202902501 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4597885 PubMed]
+
##'''Update:''' Fefer A, Einstein AB, Thomas ED, Buckner CD, Clift RA, Glucksberg H, Neiman PE, Storb R. Bone-marrow transplantation for hematologic neoplasia in 16 patients with identical twins. N Engl J Med. 1974 Jun 20;290(25):1389-93. [https://doi.org/10.1056/NEJM197406202902501 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4597885/ PubMed]
#Thomas ED, Sanders JE, Flournoy N, Johnson FL, Buckner CD, Clift RA, Fefer A, Goodell BW, Storb R, Weiden PL. Marrow transplantation for patients with acute lymphoblastic leukemia in remission. Blood. 1979 Aug;54(2):468-76. [http://www.bloodjournal.org/content/54/2/468.long link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/378292 PubMed]
+
#Thomas ED, Sanders JE, Flournoy N, Johnson FL, Buckner CD, Clift RA, Fefer A, Goodell BW, Storb R, Weiden PL. Marrow transplantation for patients with acute lymphoblastic leukemia in remission. Blood. 1979 Aug;54(2):468-76. [https://doi.org/10.1182/blood.V54.2.468.468 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/378292/ PubMed]
#Blume KG, Beutler E, Bross KJ, Chillar RK, Ellington OB, Fahey JL, Farbstein MJ, Forman SJ, Schmidt GM, Scott EP, Spruce WE, Turner MA, Wolf JL. Bone-marrow ablation and allogeneic marrow transplantation in acute leukemia. N Engl J Med. 1980 May 8;302(19):1041-6. [https://doi.org/10.1056/NEJM198005083021901 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6245359 PubMed]
+
#Blume KG, Beutler E, Bross KJ, Chillar RK, Ellington OB, Fahey JL, Farbstein MJ, Forman SJ, Schmidt GM, Scott EP, Spruce WE, Turner MA, Wolf JL. Bone-marrow ablation and allogeneic marrow transplantation in acute leukemia. N Engl J Med. 1980 May 8;302(19):1041-6. [https://doi.org/10.1056/NEJM198005083021901 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6245359/ PubMed]
#Johnson FL, Thomas ED, Clark BS, Chard RL, Hartmann JR, Storb R. A comparison of marrow transplantation with chemotherapy for children with acute lymphoblastic leukemia in second or subsequent remission. N Engl J Med. 1981 Oct 8;305(15):846-51. [https://doi.org/10.1056/NEJM198110083051502 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7024804 PubMed]
+
#Johnson FL, Thomas ED, Clark BS, Chard RL, Hartmann JR, Storb R. A comparison of marrow transplantation with chemotherapy for children with acute lymphoblastic leukemia in second or subsequent remission. N Engl J Med. 1981 Oct 8;305(15):846-51. [https://doi.org/10.1056/NEJM198110083051502 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7024804/ PubMed]
#Fefer A, Cheever MA, Greenberg PD, Appelbaum FR, Boyd CN, Buckner CD, Kaplan HG, Ramberg R, Sanders JE, Storb R, Thomas ED. Treatment of chronic granulocytic leukemia with chemoradiotherapy and transplantation of marrow from identical twins. N Engl J Med. 1982 Jan 14;306(2):63-8. [https://doi.org/10.1056/NEJM198201143060202 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7031474 PubMed]
+
#Fefer A, Cheever MA, Greenberg PD, Appelbaum FR, Boyd CN, Buckner CD, Kaplan HG, Ramberg R, Sanders JE, Storb R, Thomas ED. Treatment of chronic granulocytic leukemia with chemoradiotherapy and transplantation of marrow from identical twins. N Engl J Med. 1982 Jan 14;306(2):63-8. [https://doi.org/10.1056/NEJM198201143060202 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7031474/ PubMed]
#Goldman JM, Apperley JF, Jones L, Marcus R, Goolden AW, Batchelor R, Hale G, Waldmann H, Reid CD, Hows J, Gordon-Smith E, Catovsky D, Galton DAG. Bone marrow transplantation for patients with chronic myeloid leukemia. N Engl J Med. 1986 Jan 23;314(4):202-7. [https://pubmed.ncbi.nlm.nih.gov/3510388 PubMed]
+
#Goldman JM, Apperley JF, Jones L, Marcus R, Goolden AW, Batchelor R, Hale G, Waldmann H, Reid CD, Hows J, Gordon-Smith E, Catovsky D, Galton DAG. Bone marrow transplantation for patients with chronic myeloid leukemia. N Engl J Med. 1986 Jan 23;314(4):202-7. [https://pubmed.ncbi.nlm.nih.gov/3510388/ PubMed]
#Kersey JH, Weisdorf D, Nesbit ME, LeBien TW, Woods WG, McGlave PB, Kim T, Vallera DA, Goldman AI, Bostrom B, Hurd D, Ramsay NKC. Comparison of autologous and allogeneic bone marrow transplantation for treatment of high-risk refractory acute lymphoblastic leukemia. N Engl J Med. 1987 Aug 20;317(8):461-7. [https://doi.org/10.1056/NEJM198708203170801 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3302708 PubMed]
+
#Kersey JH, Weisdorf D, Nesbit ME, LeBien TW, Woods WG, McGlave PB, Kim T, Vallera DA, Goldman AI, Bostrom B, Hurd D, Ramsay NKC. Comparison of autologous and allogeneic bone marrow transplantation for treatment of high-risk refractory acute lymphoblastic leukemia. N Engl J Med. 1987 Aug 20;317(8):461-7. [https://doi.org/10.1056/NEJM198708203170801 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3302708/ PubMed]
#Brochstein JA, Kernan NA, Groshen S, Cirrincione C, Shank B, Emanuel D, Laver J, O'Reilly RJ. Allogeneic bone marrow transplantation after hyperfractionated total-body irradiation and cyclophosphamide in children with acute leukemia. N Engl J Med. 1987 Dec 24;317(26):1618-24. [https://doi.org/10.1056/NEJM198712243172602 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3317056 PubMed]
+
#Brochstein JA, Kernan NA, Groshen S, Cirrincione C, Shank B, Emanuel D, Laver J, O'Reilly RJ. Allogeneic bone marrow transplantation after hyperfractionated total-body irradiation and cyclophosphamide in children with acute leukemia. N Engl J Med. 1987 Dec 24;317(26):1618-24. [https://doi.org/10.1056/NEJM198712243172602 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3317056/ PubMed]
#'''LALA 87:''' Sebban C, Lepage E, Vernant JP, Gluckman E, Attal M, Reiffers J, Sutton L, Racadot E, Michallet M, Maraninchi D, Dreyfus F, Fiere D; French Group of Therapy of Adult Acute Lymphoblastic Leukemia. Allogeneic bone marrow transplantation in adult acute lymphoblastic leukemia in first complete remission: a comparative study. J Clin Oncol. 1994 Dec;12(12):2580-7. [https://doi.org/10.1200/JCO.1994.12.12.2580 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7989932 PubMed]
+
#'''LALA 87:''' Sebban C, Lepage E, Vernant JP, Gluckman E, Attal M, Reiffers J, Sutton L, Racadot E, Michallet M, Maraninchi D, Dreyfus F, Fiere D; French Group of Therapy of Adult Acute Lymphoblastic Leukemia. Allogeneic bone marrow transplantation in adult acute lymphoblastic leukemia in first complete remission: a comparative study. J Clin Oncol. 1994 Dec;12(12):2580-7. [https://doi.org/10.1200/JCO.1994.12.12.2580 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7989932/ PubMed]
##'''Update:''' Thiebaut A, Vernant JP, Degos L, Huguet FR, Reiffers J, Sebban C, Lepage E, Thomas X, Fière D. Adult acute lymphocytic leukemia study testing chemotherapy and autologous and allogeneic transplantation: a follow-up report of the French protocol LALA 87. Hematol Oncol Clin North Am. 2000 Dec;14(6):1353-66. [https://doi.org/10.1016/s0889-8588(05)70190-8 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11147227 PubMed]
+
##'''Update:''' Thiebaut A, Vernant JP, Degos L, Huguet FR, Reiffers J, Sebban C, Lepage E, Thomas X, Fière D. Adult acute lymphocytic leukemia study testing chemotherapy and autologous and allogeneic transplantation: a follow-up report of the French protocol LALA 87. Hematol Oncol Clin North Am. 2000 Dec;14(6):1353-66. [https://doi.org/10.1016/s0889-8588(05)70190-8 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11147227/ PubMed]
#Zittoun RA, Mandelli F, Willemze R, de Witte T, Labar B, Resegotti L, Leoni F, Damasio E, Visani G, Papa G, Caronia F, Hayat M, Stryckmans P, Rotoli B, Leoni P, Peetermans ME, Dardenne M, Vegna ML, Petti MC, Solbu G, Suciu S; [[Study_Groups#EORTC|EORTC]]; Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. N Engl J Med. 1995 Jan 26;332(4):217-23. [https://doi.org/10.1056/NEJM199501263320403 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/7808487 PubMed]
+
#Zittoun RA, Mandelli F, Willemze R, de Witte T, Labar B, Resegotti L, Leoni F, Damasio E, Visani G, Papa G, Caronia F, Hayat M, Stryckmans P, Rotoli B, Leoni P, Peetermans ME, Dardenne M, Vegna ML, Petti MC, Solbu G, Suciu S; [[Study_Groups#EORTC|EORTC]]; Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. N Engl J Med. 1995 Jan 26;332(4):217-23. [https://doi.org/10.1056/NEJM199501263320403 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/7808487/ PubMed]
#Hansen JA, Gooley TA, Martin PJ, Appelbaum F, Chauncey TR, Clift RA, Petersdorf EW, Radich J, Sanders JE, Storb RF, Sullivan KM, Anasetti C. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med. 1998 Apr 2;338(14):962-8. [https://doi.org/10.1056/NEJM199804023381405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9521984 PubMed]
+
#Hansen JA, Gooley TA, Martin PJ, Appelbaum F, Chauncey TR, Clift RA, Petersdorf EW, Radich J, Sanders JE, Storb RF, Sullivan KM, Anasetti C. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med. 1998 Apr 2;338(14):962-8. [https://doi.org/10.1056/NEJM199804023381405 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9521984/ PubMed]
#'''LALA-94:''' Thomas X, Boiron JM, Huguet F, Dombret H, Bradstock K, Vey N, Kovacsovics T, Delannoy A, Fegueux N, Fenaux P, Stamatoullas A, Vernant JP, Tournilhac O, Buzyn A, Reman O, Charrin C, Boucheix C, Gabert J, Lhéritier V, Fiere D. Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol. 2004 Oct 15;22(20):4075-86. Epub 2004 Sep 7. [https://doi.org/10.1200/jco.2004.10.050 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15353542 PubMed] NCT00002700
+
#'''LALA-94:''' Thomas X, Boiron JM, Huguet F, Dombret H, Bradstock K, Vey N, Kovacsovics T, Delannoy A, Fegueux N, Fenaux P, Stamatoullas A, Vernant JP, Tournilhac O, Buzyn A, Reman O, Charrin C, Boucheix C, Gabert J, Lhéritier V, Fiere D. Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol. 2004 Oct 15;22(20):4075-86. Epub 2004 Sep 7. [https://doi.org/10.1200/jco.2004.10.050 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15353542/ PubMed] [https://clinicaltrials.gov/study/NCT00002700 NCT00002700]
##'''Update:''' Vey N, Thomas X, Picard C, Kovascovicz T, Charin C, Cayuela JM, Dombret H, Dastugue N, Huguet F, Bastard C, Stamatoulas A, Giollant M, Tournilhac O, Macintyre E, Buzyn A, Bories D, Kuentz M, Dreyfus F, Delannoy A, Raynaud S, Gratecos N, Bordessoule D, de Botton S, Preudhomme C, Reman O, Troussard X, Pigneux A, Bilhou C, Vernant JP, Boucheix C, Gabert J; Swiss Group for Clinical Cancer Research. Allogeneic stem cell transplantation improves the outcome of adults with t(1;19)/E2A-PBX1 and t(4;11)/MLL-AF4 positive B-cell acute lymphoblastic leukemia: results of the prospective multicenter LALA-94 study. Leukemia. 2006 Dec;20(12):2155-61. Epub 2006 Oct 12. [https://doi.org/10.1038/sj.leu.2404420 link to original article] [https://pubmed.ncbi.nlm.nih.gov/17039234 PubMed]
+
##'''Update:''' Vey N, Thomas X, Picard C, Kovascovicz T, Charin C, Cayuela JM, Dombret H, Dastugue N, Huguet F, Bastard C, Stamatoulas A, Giollant M, Tournilhac O, Macintyre E, Buzyn A, Bories D, Kuentz M, Dreyfus F, Delannoy A, Raynaud S, Gratecos N, Bordessoule D, de Botton S, Preudhomme C, Reman O, Troussard X, Pigneux A, Bilhou C, Vernant JP, Boucheix C, Gabert J; Swiss Group for Clinical Cancer Research. Allogeneic stem cell transplantation improves the outcome of adults with t(1;19)/E2A-PBX1 and t(4;11)/MLL-AF4 positive B-cell acute lymphoblastic leukemia: results of the prospective multicenter LALA-94 study. Leukemia. 2006 Dec;20(12):2155-61. Epub 2006 Oct 12. [https://doi.org/10.1038/sj.leu.2404420 link to original article] [https://pubmed.ncbi.nlm.nih.gov/17039234/ PubMed]
#'''9005-2003:''' Bornhäuser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, Baurmann H, Schäfer-Eckart K, Holler E, Kröger N, Schmid C, Einsele H, Kiehl MG, Hiddemann W, Schwerdtfeger R, Buchholz S, Dreger P, Neubauer A, Berdel WE, Ehninger G, Beelen DW, Schetelig J, Stelljes M. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012 Oct;13(10):1035-44. Epub 2012 Sep 7. [https://doi.org/10.1016/S1470-2045(12)70349-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/22959335 PubMed] NCT00150878
+
#'''9005-2003:''' Bornhäuser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, Baurmann H, Schäfer-Eckart K, Holler E, Kröger N, Schmid C, Einsele H, Kiehl MG, Hiddemann W, Schwerdtfeger R, Buchholz S, Dreger P, Neubauer A, Berdel WE, Ehninger G, Beelen DW, Schetelig J, Stelljes M. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012 Oct;13(10):1035-44. Epub 2012 Sep 7. [https://doi.org/10.1016/S1470-2045(12)70349-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/22959335/ PubMed] [https://clinicaltrials.gov/study/NCT00150878 NCT00150878]
#'''Retrospective:''' Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, Saber W. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Blood. 2013 Dec 5;122(24):3863-70. Epub 2013 Sep 24. [http://www.bloodjournal.org/content/122/24/3863.long link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854108/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/24065243 PubMed]
+
#'''Retrospective:''' Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, Saber W. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Blood. 2013 Dec 5;122(24):3863-70. Epub 2013 Sep 24. [https://doi.org/10.1182/blood-2013-07-514448 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3854108/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/24065243/ PubMed]
#'''SWOG S9920:''' NCT00005866
+
#Zhang H, Fan Z, Huang F, Han L, Xu Y, Xu N, Deng L, Wang S, Lin D, Luo X, Zhang Q, Liu X, Li X, Liang X, Xie S, Qu H, Yu S, Zhou H, Shi P, Xuan L, Lin R, Liu H, Jin H, Sun J, Liu Q. Busulfan Plus Cyclophosphamide Versus Total Body Irradiation Plus Cyclophosphamide for Adults Acute B Lymphoblastic Leukemia: An Open-Label, Multicenter, Phase III Trial. J Clin Oncol. 2023 Jan 10;41(2):343-353. Epub 2022 Sep 9. [https://doi.org/10.1200/JCO.22.00767 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839269/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/36084276/ PubMed] [https://clinicaltrials.gov/study/NCT02670252 NCT02670252]
 +
#'''SWOG S9920:''' [https://clinicaltrials.gov/study/NCT00005866 NCT00005866]
 
==Etoposide & TBI {{#subobject:b389e1|Regimen=1}}==
 
==Etoposide & TBI {{#subobject:b389e1|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
Line 442: Line 571:
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
Line 466: Line 595:
 
*[[Etoposide (Vepesid)]] 60 mg/kg (maximum dose of 3600 mg) IV once on day -3
 
*[[Etoposide (Vepesid)]] 60 mg/kg (maximum dose of 3600 mg) IV once on day -3
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy twice per day in 6 fractions on days -6 to -4 with lung shielding at 10 Gy (total dose: 1200 cGy)
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy twice per day in 6 fractions on days -6 to -4 with lung shielding at 1000 cGy (total dose: 1200 cGy)
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="45f841" />
 
<section end="45f841" />
Line 476: Line 606:
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
Line 484: Line 614:
 
|2013-2018
 
|2013-2018
 
| style="background-color:#1a9851" |Phase 3 (C)
 
| style="background-color:#1a9851" |Phase 3 (C)
|1a. [[#Busulfan.2C_Fludarabine.2C_Thiotepa_99|Busulfan, Fludarabine, Thiotepa]]<br>1b. [[#Fludarabine.2C_Thiotepa.2C_Treosulfan_77|Fludarabine, Thiotepa, Treosulfan]]
+
|1a. [[#Busulfan.2C_Fludarabine.2C_Thiotepa_999|Busulfan, Fludarabine, Thiotepa]]<br>1b. [[#Fludarabine.2C_Thiotepa.2C_Treosulfan_999|Fludarabine, Thiotepa, Treosulfan]]
| style="background-color:#1a9850" |Superior OS
+
| style="background-color:#1a9850" |Superior OS (primary endpoint)
 
|-
 
|-
 
|}
 
|}
Line 494: Line 624:
 
*[[Etoposide (Vepesid)]] 1800 mg/m<sup>2</sup> (maximum dose of 3600 mg) IV once on day -3
 
*[[Etoposide (Vepesid)]] 1800 mg/m<sup>2</sup> (maximum dose of 3600 mg) IV once on day -3
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy twice per day in 6 fractions on days -6 to -4 with lung shielding at 10 Gy (total dose: 1200 cGy)
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy twice per day in 6 fractions on days -6 to -4 with lung shielding at 1000 cGy (total dose: 1200 cGy)
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="45u7g1" />
 
<section end="45u7g1" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #3, 13.2 Gy {{#subobject:e4216b|Variant=1}}===
+
 
{| class="wikitable" style="width: 40%; text-align:center;"
+
===Regimen variant #3, 1320 cGy {{#subobject:e4216b|Variant=1}}===
! style="width: 25%" |Study
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[http://www.bloodjournal.org/content/106/12/3760.long Rowe et al. 2005 (MRC UKALL XII/ECOG E2993)]
+
|[https://doi.org/10.1182/blood-2005-04-1623 Rowe et al. 2005 (MRC UKALL XII/ECOG E2993)]
| style="background-color:#91cf61" |Non-randomized portion of RCT
+
|1993-2003
 +
|style="background-color:#91cf61"|Non-randomized part of phase 3 RCT
 
|-
 
|-
 
|}
 
|}
Line 519: Line 653:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="e4216b" />
 
<section end="e4216b" />
 
</div>
 
</div>
 
===References===
 
===References===
#Balduzzi A, Valsecchi MG, Uderzo C, De Lorenzo P, Klingebiel T, Peters C, Stary J, Felice MS, Magyarosy E, Conter V, Reiter A, Messina C, Gadner H, Schrappe M. Chemotherapy versus allogeneic transplantation for very-high-risk childhood acute lymphoblastic leukaemia in first complete remission: comparison by genetic randomisation in an international prospective study. Lancet. 2005 Aug 20-26;366(9486):635-42. [https://doi.org/10.1016/s0140-6736(05)66998-x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16112299 PubMed]
+
#Balduzzi A, Valsecchi MG, Uderzo C, De Lorenzo P, Klingebiel T, Peters C, Stary J, Felice MS, Magyarosy E, Conter V, Reiter A, Messina C, Gadner H, Schrappe M. Chemotherapy versus allogeneic transplantation for very-high-risk childhood acute lymphoblastic leukaemia in first complete remission: comparison by genetic randomisation in an international prospective study. Lancet. 2005 Aug 20-26;366(9486):635-42. [https://doi.org/10.1016/s0140-6736(05)66998-x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16112299/ PubMed]
#'''MRC UKALL XII/ECOG E2993:''' Rowe JM, Buck G, Burnett AK, Chopra R, Wiernik PH, Richards SM, Lazarus HM, Franklin IM, Litzow MR, Ciobanu N, Prentice HG, Durrant J, Tallman MS, Goldstone AH; ECOG; MRC/NCRI Adult Leukemia Working Party. Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood. 2005 Dec 1;106(12):3760-7. Epub 2005 Aug 16. [http://www.bloodjournal.org/content/106/12/3760.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16105981 PubMed] NCT00002514
+
#'''MRC UKALL XII/ECOG E2993:''' Rowe JM, Buck G, Burnett AK, Chopra R, Wiernik PH, Richards SM, Lazarus HM, Franklin IM, Litzow MR, Ciobanu N, Prentice HG, Durrant J, Tallman MS, Goldstone AH; ECOG; MRC/NCRI Adult Leukemia Working Party. Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood. 2005 Dec 1;106(12):3760-7. Epub 2005 Aug 16. [https://doi.org/10.1182/blood-2005-04-1623 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16105981/ PubMed] [https://clinicaltrials.gov/study/NCT00002514 NCT00002514]
##'''Update:''' Goldstone AH, Richards SM, Lazarus HM, Tallman MS, Buck G, Fielding AK, Burnett AK, Chopra R, Wiernik PH, Foroni L, Paietta E, Litzow MR, Marks DI, Durrant J, McMillan A, Franklin IM, Luger S, Ciobanu N, Rowe JM. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008 Feb 15;111(4):1827-33. Epub 2007 Nov 29. [http://www.bloodjournal.org/content/111/4/1827.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/18048644 PubMed]
+
##'''Update:''' Goldstone AH, Richards SM, Lazarus HM, Tallman MS, Buck G, Fielding AK, Burnett AK, Chopra R, Wiernik PH, Foroni L, Paietta E, Litzow MR, Marks DI, Durrant J, McMillan A, Franklin IM, Luger S, Ciobanu N, Rowe JM. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008 Feb 15;111(4):1827-33. Epub 2007 Nov 29. [https://doi.org/10.1182/blood-2007-10-116582 link to original article] [https://pubmed.ncbi.nlm.nih.gov/18048644/ PubMed]
##'''Update:''' Fielding AK, Rowe JM, Richards SM, Buck G, Moorman AV, Durrant IJ, Marks DI, McMillan AK, Litzow MR, Lazarus HM, Foroni L, Dewald G, Franklin IM, Luger SM, Paietta E, Wiernik PH, Tallman MS, Goldstone AH. Prospective outcome data on 267 unselected adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia confirms superiority of allogeneic transplantation over chemotherapy in the pre-imatinib era: results from the International ALL Trial MRC UKALLXII/ECOG2993. Blood. 2009 May 7;113(19):4489-96. Epub 2009 Feb 24. [http://www.bloodjournal.org/content/113/19/4489.long link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188540/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19244158 PubMed]
+
##'''Update:''' Fielding AK, Rowe JM, Richards SM, Buck G, Moorman AV, Durrant IJ, Marks DI, McMillan AK, Litzow MR, Lazarus HM, Foroni L, Dewald G, Franklin IM, Luger SM, Paietta E, Wiernik PH, Tallman MS, Goldstone AH. Prospective outcome data on 267 unselected adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia confirms superiority of allogeneic transplantation over chemotherapy in the pre-imatinib era: results from the International ALL Trial MRC UKALLXII/ECOG2993. Blood. 2009 May 7;113(19):4489-96. Epub 2009 Feb 24. [https://doi.org/10.1182/blood-2009-01-199380 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188540/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19244158/ PubMed]
##'''Update:''' Fielding AK, Rowe JM, Buck G, Foroni L, Gerrard G, Litzow MR, Lazarus H, Luger SM, Marks DI, McMillan AK, Moorman AV, Patel B, Paietta E, Tallman MS, Goldstone AH. UKALLXII/ECOG2993: addition of imatinib to a standard treatment regimen enhances long-term outcomes in Philadelphia positive acute lymphoblastic leukemia. Blood. 2014 Feb 6;123(6):843-50. Epub 2013 Nov 25. [http://www.bloodjournal.org/content/123/6/843.full link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916877/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/24277073 PubMed]
+
##'''Update:''' Fielding AK, Rowe JM, Buck G, Foroni L, Gerrard G, Litzow MR, Lazarus H, Luger SM, Marks DI, McMillan AK, Moorman AV, Patel B, Paietta E, Tallman MS, Goldstone AH. UKALLXII/ECOG2993: addition of imatinib to a standard treatment regimen enhances long-term outcomes in Philadelphia positive acute lymphoblastic leukemia. Blood. 2014 Feb 6;123(6):843-50. Epub 2013 Nov 25. [https://doi.org/10.1182/blood-2013-09-529008 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916877/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/24277073/ PubMed]
#'''ALL-SCT-BFM-2003:''' Peters C, Schrappe M, von Stackelberg A, Schrauder A, Bader P, Ebell W, Lang P, Sykora KW, Schrum J, Kremens B, Ehlert K, Albert MH, Meisel R, Matthes-Martin S, Gungor T, Holter W, Strahm B, Gruhn B, Schulz A, Woessmann W, Poetschger U, Zimmermann M, Klingebiel T. Stem-cell transplantation in children with acute lymphoblastic leukemia: a prospective international multicenter trial comparing sibling donors with matched unrelated donors-the ALL-SCT-BFM-2003 trial. J Clin Oncol. 2015 Apr 10;33(11):1265-74. Epub 2015 Mar 9. [https://doi.org/10.1200/jco.2014.58.9747 link to original article] [https://pubmed.ncbi.nlm.nih.gov/25753432 PubMed] NCT01423747
+
#'''ALL-SCT-BFM-2003:''' Peters C, Schrappe M, von Stackelberg A, Schrauder A, Bader P, Ebell W, Lang P, Sykora KW, Schrum J, Kremens B, Ehlert K, Albert MH, Meisel R, Matthes-Martin S, Gungor T, Holter W, Strahm B, Gruhn B, Schulz A, Woessmann W, Poetschger U, Zimmermann M, Klingebiel T. Stem-cell transplantation in children with acute lymphoblastic leukemia: a prospective international multicenter trial comparing sibling donors with matched unrelated donors-the ALL-SCT-BFM-2003 trial. J Clin Oncol. 2015 Apr 10;33(11):1265-74. Epub 2015 Mar 9. [https://doi.org/10.1200/jco.2014.58.9747 link to original article] [https://pubmed.ncbi.nlm.nih.gov/25753432/ PubMed] [https://clinicaltrials.gov/study/NCT01423747 NCT01423747]
#'''FORUM:''' Peters C, Dalle JH, Locatelli F, Poetschger U, Sedlacek P, Buechner J, Shaw PJ, Staciuk R, Ifversen M, Pichler H, Vettenranta K, Svec P, Aleinikova O, Stein J, Güngör T, Toporski J, Truong TH, Diaz-de-Heredia C, Bierings M, Ariffin H, Essa M, Burkhardt B, Schultz K, Meisel R, Lankester A, Ansari M, Schrappe M, von Stackelberg A, Balduzzi A, Corbacioglu S, Bader P; IBFM Study Group; IntReALL Study Group; I-BFM SCT Study Group; EBMT Paediatric Diseases Working Party. Total Body Irradiation or Chemotherapy Conditioning in Childhood ALL: A Multinational, Randomized, Noninferiority Phase III Study. J Clin Oncol. 2021 Feb 1;39(4):295-307. Epub 2020 Dec 17. [https://doi.org/10.1200/jco.20.02529 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8078415/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/33332189/ PubMed] NCT01949129
+
#'''FORUM:''' Peters C, Dalle JH, Locatelli F, Poetschger U, Sedlacek P, Buechner J, Shaw PJ, Staciuk R, Ifversen M, Pichler H, Vettenranta K, Svec P, Aleinikova O, Stein J, Güngör T, Toporski J, Truong TH, Diaz-de-Heredia C, Bierings M, Ariffin H, Essa M, Burkhardt B, Schultz K, Meisel R, Lankester A, Ansari M, Schrappe M, von Stackelberg A, Balduzzi A, Corbacioglu S, Bader P; IBFM Study Group; IntReALL Study Group; I-BFM SCT Study Group; EBMT Paediatric Diseases Working Party. Total Body Irradiation or Chemotherapy Conditioning in Childhood ALL: A Multinational, Randomized, Noninferiority Phase III Study. J Clin Oncol. 2021 Feb 1;39(4):295-307. Epub 2020 Dec 17. [https://doi.org/10.1200/jco.20.02529 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8078415/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/33332189/ PubMed] [https://clinicaltrials.gov/study/NCT01949129 NCT01949129]
 
==Fludarabine, Busulfan, Cyclophosphamide {{#subobject:84acb0|Regimen=1}}==
 
==Fludarabine, Busulfan, Cyclophosphamide {{#subobject:84acb0|Regimen=1}}==
 
FluBuCy: '''<u>Flu</u>'''darabine, '''<u>Bu</u>'''sulfan, '''<u>Cy</u>'''clophosphamide
 
FluBuCy: '''<u>Flu</u>'''darabine, '''<u>Bu</u>'''sulfan, '''<u>Cy</u>'''clophosphamide
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen {{#subobject:bfe434|Variant=1}}===
+
===Regimen variant #1, oral {{#subobject:bfe434|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://doi.org/10.1016/S1470-2045(14)70161-5 Glass et al. 2014 (DSHNHL R3)]
 
|[https://doi.org/10.1016/S1470-2045(14)70161-5 Glass et al. 2014 (DSHNHL R3)]
 +
|2004-06-16 to 2009-03-24
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
Line 547: Line 684:
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 25 mg/m<sup>2</sup>/day IV on days -8 to -4
 
*[[Fludarabine (Fludara)]] 25 mg/m<sup>2</sup>/day IV on days -8 to -4
*[[Busulfan (Myleran)]] by one of the following:
+
*[[Busulfan (Myleran)]] 4 mg/kg/day PO on days -6 to -4
**Oral: 4 mg/kg/day PO on days -6 to -4
 
**Intravenous: 3.2 mg/kg/day IV on days -6 to -4
 
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg/day IV on days -3 and -2
 
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg/day IV on days -3 and -2
====Immunosuppressive therapy====
+
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2 mg/kg IV from day -3 to -1 (''unclear if this is a total dose or a daily dose'')
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2 mg/kg IV from day -3 to -1 (''unclear if this is a total dose or a daily dose'')
 
**Option also to use [[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius S]] at a higher dose of 10 mg/kg
 
**Option also to use [[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius S]] at a higher dose of 10 mg/kg
 +
*[[Tacrolimus (Prograf)]] 8 to 12 mcg/L (route/frequency not specified) starting on day -1, tapered from day +100 in absence of GVHD
 +
*[[Mycophenolate mofetil (CellCept)]] 1000 mg (route not specified) twice per day from day +1 to +28
 +
'''One course'''
 +
</div>
 +
<section end="bfe434" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #2, intravenous {{#subobject:bfe434|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://doi.org/10.1016/S1470-2045(14)70161-5 Glass et al. 2014 (DSHNHL R3)]
 +
|2004-06-16 to 2009-03-24
 +
| style="background-color:#91cf61" |Phase 2
 +
|-
 +
|}
 +
''This is described by the authors as a lymphoma-directed myeloablative conditioning regimen''
 +
<section begin="bfe435" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 25 mg/m<sup>2</sup>/day IV on days -8 to -4
 +
*[[Busulfan (Myleran)]] 3.2 mg/kg/day IV on days -6 to -4
 +
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg/day IV on days -3 and -2
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2 mg/kg IV from day -3 to -1 (''unclear if this is a total dose or a daily dose'')
 +
**Option also to use [[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius S]] at a higher dose of 10 mg/kg
 
*[[Tacrolimus (Prograf)]] 8 to 12 mcg/L (route/frequency not specified) starting on day -1, tapered from day +100 in absence of GVHD
 
*[[Tacrolimus (Prograf)]] 8 to 12 mcg/L (route/frequency not specified) starting on day -1, tapered from day +100 in absence of GVHD
 
*[[Mycophenolate mofetil (CellCept)]] 1000 mg (route not specified) twice per day from day +1 to +28
 
*[[Mycophenolate mofetil (CellCept)]] 1000 mg (route not specified) twice per day from day +1 to +28
 +
'''One course'''
 
</div>
 
</div>
<section end="bfe434" />
+
<section end="bfe435" />
 
</div>
 
</div>
 
===References===
 
===References===
 
+
#'''DSHNHL R3:''' Glass B, Hasenkamp J, Wulf G, Dreger P, Pfreundschuh M, Gramatzki M, Silling G, Wilhelm C, Zeis M, Görlitz A, Pfeiffer S, Hilgers R, Truemper L, Schmitz N; German High-Grade Lymphoma Study Group. Rituximab after lymphoma-directed conditioning and allogeneic stem-cell transplantation for relapsed and refractory aggressive non-Hodgkin lymphoma (DSHNHL R3): an open-label, randomised, phase 2 trial. Lancet Oncol. 2014 Jun;15(7):757-66. Epub 2014 May 11. [https://doi.org/10.1016/S1470-2045(14)70161-5 link to original article] [http://www.dshnhl.org/app/download/9495510598/Studienprotokoll+DSHNHL+alloFBC+final+vollst.pdf link to original protocol (in German)] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/24827808/ PubMed] [https://clinicaltrials.gov/study/NCT00785330 NCT00785330]
#'''DSHNHL R3:''' Glass B, Hasenkamp J, Wulf G, Dreger P, Pfreundschuh M, Gramatzki M, Silling G, Wilhelm C, Zeis M, Görlitz A, Pfeiffer S, Hilgers R, Truemper L, Schmitz N; German High-Grade Lymphoma Study Group. Rituximab after lymphoma-directed conditioning and allogeneic stem-cell transplantation for relapsed and refractory aggressive non-Hodgkin lymphoma (DSHNHL R3): an open-label, randomised, phase 2 trial. Lancet Oncol. 2014 Jun;15(7):757-66. Epub 2014 May 11. [https://doi.org/10.1016/S1470-2045(14)70161-5 link to original article] [http://www.dshnhl.org/app/download/9495510598/Studienprotokoll+DSHNHL+alloFBC+final+vollst.pdf link to original protocol (in German)] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/24827808 PubMed] NCT00785330
 
 
==Fludarabine & TBI for haploidentical transplant==
 
==Fludarabine & TBI for haploidentical transplant==
 
Flu/TBI: <u>'''Flu'''</u>darabine and '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
 
Flu/TBI: <u>'''Flu'''</u>darabine and '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen===
 
===Regimen===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://doi.org/10.1016/j.bbmt.2015.03.003 Soloman et al. 2014]
 
|[https://doi.org/10.1016/j.bbmt.2015.03.003 Soloman et al. 2014]
 +
|2012-04 to 2014-05
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|}
 
|}
Line 580: Line 746:
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup>/day IV on days -7 to -5 (3 consecutive days)
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup>/day IV on days -7 to -5 (3 consecutive days)
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation]], 12 Gy total
+
*[[External_beam_radiotherapy|Total body irradiation]] 150 cGy twice per day on days -4 to -1 (total dose: 1200 cGy)
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
Line 587: Line 753:
 
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg (maximum daily dose of 3000 mg; route not specified) every 8 hours, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
 
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg (maximum daily dose of 3000 mg; route not specified) every 8 hours, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180
 +
'''One course'''
 
</div></div>
 
</div></div>
 
===References===
 
===References===
#Solomon SR, Sizemore CA, Sanacore M, Zhang X, Brown S, Holland HK, Morris LE, Bashey A. Total Body Irradiation-Based Myeloablative Haploidentical Stem Cell Transplantation Is a Safe and Effective Alternative to Unrelated Donor Transplantation in Patients Without Matched Sibling Donors. Biol Blood Marrow Transplant. 2015 Jul;21(7):1299-307. Epub 2015 Mar 19. [https://doi.org/10.1016/j.bbmt.2015.03.003 link to original article] [https://pubmed.ncbi.nlm.nih.gov/25797174/ PubMed]
+
#Solomon SR, Sizemore CA, Sanacore M, Zhang X, Brown S, Holland HK, Morris LE, Bashey A. Total Body Irradiation-Based Myeloablative Haploidentical Stem Cell Transplantation Is a Safe and Effective Alternative to Unrelated Donor Transplantation in Patients Without Matched Sibling Donors. Biol Blood Marrow Transplant. 2015 Jul;21(7):1299-307. Epub 2015 Mar 19. [https://doi.org/10.1016/j.bbmt.2015.03.003 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25797174/ PubMed]
 +
 
 
==BEAM {{#subobject:bda306|Regimen=1}}==
 
==BEAM {{#subobject:bda306|Regimen=1}}==
 
BEAM: '''<u>B</u>'''CNU (Carmustine), '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>M</u>'''elphalan
 
BEAM: '''<u>B</u>'''CNU (Carmustine), '''<u>E</u>'''toposide, '''<u>A</u>'''ra-C (Cytarabine), '''<u>M</u>'''elphalan
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen {{#subobject:a8d4a|Variant=1}}===
+
===Regimen variant #1 {{#subobject:a8d4a|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |Study
Line 599: Line 767:
 
|-
 
|-
 
|[https://doi.org/10.1093/oxfordjournals.annonc.a010369 Przepiorka et al. 1999]
 
|[https://doi.org/10.1093/oxfordjournals.annonc.a010369 Przepiorka et al. 1999]
| style="background-color:#91cf61" |Phase 2
 
|-
 
|[https://doi.org/10.3109/10428194.2013.838233 Sobol et al. 2013]
 
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
Line 620: Line 785:
 
*"Prophylactic antibiotics"
 
*"Prophylactic antibiotics"
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +7 and continued until engraftment
 
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +7 and continued until engraftment
 +
'''One course'''
 
</div>
 
</div>
 
<section end="a8d4a" />
 
<section end="a8d4a" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #2, attenuated {{#subobject:a8d4a3|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://doi.org/10.3109/10428194.2013.838233 Sobol et al. 2013]
 +
|2000-05 to 2012-04
 +
| style="background-color:#91cf61" |Phase 2
 +
|-
 +
|}
 +
<section begin="a8d4a3" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Carmustine (BCNU)]] 300 mg/m<sup>2</sup> IV once on day -6
 +
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days -5 to -2
 +
*[[Cytarabine (Ara-C)]] 100 mg/m<sup>2</sup> IV twice per day on days -5 to -2
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once on day -1
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 +
*[[Tacrolimus (Prograf)]]
 +
*[[Methotrexate (MTX)]]
 +
'''One course'''
 +
</div>
 +
<section end="a8d4a3" />
 
</div>
 
</div>
 
===References===
 
===References===
#Przepiorka D, van Besien K, Khouri I, Hagemeister F, Samuels B, Folloder J, Ueno NT, Molldrem J, Mehra R, Körbling M, Giralt S, Gajewski J, Donato M, Cleary K, Claxton D, Braunschweig I, Andersson B, Anderlini P, Champlin R. Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. Ann Oncol. 1999 May;10(5):527-32. [https://doi.org/10.1093/oxfordjournals.annonc.a010369 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/10416001 PubMed]
+
#Przepiorka D, van Besien K, Khouri I, Hagemeister F, Samuels B, Folloder J, Ueno NT, Molldrem J, Mehra R, Körbling M, Giralt S, Gajewski J, Donato M, Cleary K, Claxton D, Braunschweig I, Andersson B, Anderlini P, Champlin R. Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. Ann Oncol. 1999 May;10(5):527-32. [https://doi.org/10.1093/oxfordjournals.annonc.a010369 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/10416001/ PubMed]
#Sobol U, Rodriguez T, Smith S, Go A, Vimr R, Parthasarathy M, Guo R, Stiff P. Seven-year follow-up of allogeneic transplant using BCNU, etoposide, cytarabine and melphalan chemotherapy in patients with Hodgkin lymphoma after autograft failure: importance of minimal residual disease. Leuk Lymphoma. 2014 Jun;55(6):1281-7. Epub 2013 Oct 3. [https://doi.org/10.3109/10428194.2013.838233 link to original article] [https://pubmed.ncbi.nlm.nih.gov/23987822 PubMed]
+
#Sobol U, Rodriguez T, Smith S, Go A, Vimr R, Parthasarathy M, Guo R, Stiff P. Seven-year follow-up of allogeneic transplant using BCNU, etoposide, cytarabine and melphalan chemotherapy in patients with Hodgkin lymphoma after autograft failure: importance of minimal residual disease. Leuk Lymphoma. 2014 Jun;55(6):1281-7. Epub 2013 Oct 3. [https://doi.org/10.3109/10428194.2013.838233 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23987822/ PubMed]
 +
 
 
==BFR {{#subobject:c2659b|Regimen=1}}==
 
==BFR {{#subobject:c2659b|Regimen=1}}==
 
BFR: '''<u>B</u>'''endamustine, '''<u>F</u>'''ludarabine, '''<u>R</u>'''ituximab
 
BFR: '''<u>B</u>'''endamustine, '''<u>F</u>'''ludarabine, '''<u>R</u>'''ituximab
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:41fd04|Variant=1}}===
 
===Regimen {{#subobject:41fd04|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260365/ Khouri et al. 2014 (MDACC 2008-0246)]
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260365/ Khouri et al. 2014 (MDACC 2008-0246)]
 +
|2009-04 to 2013-02
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
Line 649: Line 846:
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 
*See article for GVHD prophylaxis information
 
*See article for GVHD prophylaxis information
 +
'''One course'''
 
</div>
 
</div>
 
<section end="41fd04" />
 
<section end="41fd04" />
 
</div>
 
</div>
 
===References===
 
===References===
#'''MDACC 2008-0246:''' Khouri IF, Wei W, Korbling M, Turturro F, Ahmed S, Alousi A, Anderlini P, Ciurea S, Jabbour E, Oran B, Popat UR, Rondon G, Bassett RL Jr, Gulbis A. BFR (bendamustine, fludarabine, and rituximab) allogeneic conditioning for chronic lymphocytic leukemia/lymphoma: reduced myelosuppression and GVHD. Blood. 2014 Oct 2;124(14):2306-12. Epub 2014 Aug 21. [http://www.bloodjournal.org/content/124/14/2306.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260365/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25145344 PubMed] NCT00880815
+
#'''MDACC 2008-0246:''' Khouri IF, Wei W, Korbling M, Turturro F, Ahmed S, Alousi A, Anderlini P, Ciurea S, Jabbour E, Oran B, Popat UR, Rondon G, Bassett RL Jr, Gulbis A. BFR (bendamustine, fludarabine, and rituximab) allogeneic conditioning for chronic lymphocytic leukemia/lymphoma: reduced myelosuppression and GVHD. Blood. 2014 Oct 2;124(14):2306-12. Epub 2014 Aug 21. [https://doi.org/10.1182/blood-2014-07-587519 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260365/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25145344/ PubMed] [https://clinicaltrials.gov/study/NCT00880815 NCT00880815]
 +
 
 
=Reduced-intensity conditioning (RIC), all lines of therapy=
 
=Reduced-intensity conditioning (RIC), all lines of therapy=
 
==Busulfan & Fludarabine {{#subobject:3fe0f0|Regimen=1}}==
 
==Busulfan & Fludarabine {{#subobject:3fe0f0|Regimen=1}}==
Line 659: Line 858:
 
<br>Flu/Bu: '''<u>Flu</u>'''darabine & '''<u>Bu</u>'''sulfan
 
<br>Flu/Bu: '''<u>Flu</u>'''darabine & '''<u>Bu</u>'''sulfan
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen {{#subobject:a7e574|Variant=1}}===
+
===Regimen variant #1, 90/6.4 {{#subobject:a7ehw4|Variant=1}}===
{| class="wikitable sortable" style="width: 100%; text-align:center;"
+
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
!style="width: 17%"|Study
+
!style="width: 20%"|Study
!style="width: 15%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
!style="width: 17%"|Comparator
+
!style="width: 20%"|Comparator
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
!style="width: 17%"|[[Levels_of_Evidence#Comparative_toxicity|Non-relapse mortality]]
+
|-
 +
|[https://doi.org/10.1016/s0140-6736(23)00329-x de Masson et al. 2023 (CUTALLO)]
 +
|2016-06-01 to 2022-03-03
 +
| style="background-color:#1a9851" |Propensity score analysis (E-esc)
 +
|No transplant
 +
| style="background-color:#1a9850" |Superior PFS (primary endpoint)<br>Median PFS: 9 vs 3 mo<br>(HR 0.38, 95% CI 0.21-0.69)
 +
|-
 +
|}
 +
'''Diseases Studied: [[Cutaneous T-cell lymphoma]]'''
 +
<section begin="a7ehw4" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day for 3 days (days not specified)
 +
*[[Busulfan (Myleran)]] 3.2 mg/kg/day IV for 2 days (days not specified)
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 +
*[[Cyclosporine]] started on day -1, tapered on day +90 if no GVHD
 +
*[[Methotrexate (MTX)]] 15 mg/m<sup>2</sup> IV once on day +1, then 10 mg/m<sup>2</sup> IV once per day on days +3, +6, +11
 +
'''One course'''
 +
</div>
 +
<section end="a7ehw4" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #2, 125/4 {{#subobject:e2d51e|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://doi.org/10.1182/blood-2005-09-3869 Garban et al. 2006 (IFM99-03)]
 +
|2000-04 to 2004-09
 +
| style="background-color:#91cf61" |Non-randomized
 +
|-
 +
|}
 +
''This regimen was meant for patients who had an HLA-identical sibling donor, and was evaluated in multiple myeloma patients.''
 +
<section begin="e2d51e" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 25 mg/m<sup>2</sup>/day (route not specified) for 5 days (days not specified)
 +
*[[Busulfan (Myleran)]] 2 mg/kg PO once per day for 2 days (days not specified)
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)|ATG, rabbit (Imtix)]] 2.5 mg/kg IV over 12 hours once per day on days -5 to -1
 +
*[[Cyclosporine]] 3 mg/kg/day (route not specified), starting on day -1
 +
*[[Methotrexate (MTX)]] 10 mg/m<sup>2</sup> (route not specified) once per day on days +1, +3, +6
 +
'''One course'''
 +
</div>
 +
<div class="toccolours" style="background-color:#fff2ae">
 +
====Dose and schedule modifications====
 +
*Cyclosporine doses adjusted to "serum levels", tapered on day +60 to off by day +100 (if no GVHD)
 +
</div>
 +
<section end="e2d51e" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
 
 +
===Regimen variant #3, 150/6.4 {{#subobject:a7e574|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 +
!style="width: 20%"|Study
 +
!style="width: 20%"|Dates of enrollment
 +
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 20%"|Comparator
 +
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658453/ Devine et al. 2015 (CALGB 100103)]
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658453/ Devine et al. 2015 (CALGB 100103)]
 
|2004-2011
 
|2004-2011
| style="background-color:#ffffbe" |Phase 2, <20 pts in subgroup
+
| style="background-color:#91cf61" |Phase 2
| style="background-color:#d3d3d3" |
 
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
Line 678: Line 939:
 
|2013-2016
 
|2013-2016
 
| style="background-color:#1a9851" |Phase 3 (C)
 
| style="background-color:#1a9851" |Phase 3 (C)
|[[#Fludarabine_.26_Treosulfan_77|Fludarabine & Treosulfan]]
+
|[[#Fludarabine_.26_Treosulfan_888|Fludarabine & Treosulfan]]
 
| style="background-color:#eeee01" |Non-inferior EFS24
 
| style="background-color:#eeee01" |Non-inferior EFS24
| style="background-color:#d3d3d3" |
 
 
|-
 
|-
 
|}
 
|}
''This regimen is meant for related donors; only 8 patients received this regimen before the addition of ATG (rabbit) after 2006.''
+
''This regimen is meant for related donors; in CALGB 100103, 8 patients received this regimen before the addition of ATG (rabbit) after 2006.''
 
<section begin="a7e574" />
 
<section begin="a7e574" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
Line 693: Line 953:
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)|ATG (Rabbit)]] 2.5 mg/kg IV over 6 hours once per day on days -4 to -2
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
 
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 +
'''One course'''
 
</div>
 
</div>
 
<section end="a7e574" />
 
<section end="a7e574" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #4, 150/360 {{#subobject:335733|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://doi.org/10.1002/cncr.29087 Mohty et al. 2014 (ITT 08-01)]
 +
|2009-2011
 +
| style="background-color:#91cf61" |Phase 2
 +
|-
 +
|}
 +
<section begin="335733" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup>/day (route not specified) on days -6 to -2
 +
*[[Busulfan (Myleran)]] 130 mg/m<sup>2</sup> IV over 3 hours once per day on days -5 to -3
 +
====GVHD prophylaxis====
 +
*[[:Category:Antithymocyte globulin|Antithymocyte globulin (ATG)]] (source not specified) 2.5 mg/kg/day IV on days -2 & -1
 +
*As per [https://pubmed.ncbi.nlm.nih.gov/12931226 Mohty et al. 2003]
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 +
</div>
 +
<section end="335733" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #5, 180/8 {{#subobject:e2c4bf|Variant=1}}===
 +
{| class="wikitable" style="width: 40%; text-align:center;"
 +
! style="width: 25%" |Study
 +
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://doi.org/10.1182/blood.V91.3.756 Slavin et al. 1998]
 +
| style="background-color:#91cf61" |Phase 2
 +
|-
 +
|[https://doi.org/10.1200/jco.2003.12.011 Schetelig et al. 2003]
 +
| style="background-color:#91cf61" |Phase 2
 +
|-
 +
|}
 +
<section begin="e2c4bf" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -10 to -5 (6 consecutive days)
 +
*[[Busulfan (Myleran)]] 4 mg/kg/day PO on days -6 to -5 (2 consecutive days)
 +
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius]] 10 mg/kg IV once per day on days -4 to -1 (4 consecutive days)
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 +
</div>
 +
<section end="e2c4bf" />
 
</div>
 
</div>
 
===References===
 
===References===
 +
#Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G, Varadi G, Kirschbaum M, Ackerstein A, Samuel S, Amar A, Brautbar C, Ben-Tal O, Eldor A, Or R. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998 Feb 1;91(3):756-63. [https://doi.org/10.1182/blood.V91.3.756 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/9446633/ PubMed]
 +
#Schetelig J, Thiede C, Bornhauser M, Schwerdtfeger R, Kiehl M, Beyer J, Sayer HG, Kroger N, Hensel M, Scheffold C, Held TK, Hoffken K, Ho AD, Kienast J, Neubauer A, Zander AR, Fauser AA, Ehninger G, Siegert W; Cooperative German Transplant Study Group. Evidence of a graft-versus-leukemia effect in chronic lymphocytic leukemia after reduced-intensity conditioning and allogeneic stem-cell transplantation: the Cooperative German Transplant Study Group. J Clin Oncol. 2003 Jul 15;21(14):2747-53. [https://doi.org/10.1200/jco.2003.12.011 link to original article] '''contains reference to protocol''' [https://pubmed.ncbi.nlm.nih.gov/12860954/ PubMed]
 +
#'''IFM99-03:''' Garban F, Attal M, Michallet M, Hulin C, Bourhis JH, Yakoub-Agha I, Lamy T, Marit G, Maloisel F, Berthou C, Dib M, Caillot D, Deprijck B, Ketterer N, Harousseau JL, Sotto JJ, Moreau P. Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma. Blood. 2006 May 1;107(9):3474-80. Epub 2006 Jan 5. [https://doi.org/10.1182/blood-2005-09-3869 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16397129/ PubMed]
 +
##'''Pooled update:''' Moreau P, Garban F, Attal M, Michallet M, Marit G, Hulin C, Benboubker L, Doyen C, Mohty M, Yakoub-Agha I, Leyvraz S, Casassus P, Avet-Loiseau H, Garderet L, Mathiot C, Harousseau JL; IFM. Long-term follow-up results of IFM99-03 and IFM99-04 trials comparing nonmyeloablative allotransplantation with autologous transplantation in high-risk de novo multiple myeloma. Blood. 2008 Nov 1;112(9):3914-5. [https://doi.org/10.1182/blood-2008-07-168823 link to original article] [https://pubmed.ncbi.nlm.nih.gov/18948589/ PubMed]
 +
#'''ITT 08-01:''' Mohty M, Malard F, Blaise D, Milpied N, Furst S, Tabrizi R, Guillaume T, Vigouroux S, El-Cheikh J, Delaunay J, Le Gouill S, Moreau P, Labopin M, Chevallier P. Reduced-toxicity conditioning with fludarabine, once-daily intravenous busulfan, and antithymocyte globulins prior to allogeneic stem cell transplantation: results of a multicenter prospective phase 2 trial. Cancer. 2015 Feb 15;121(4):562-9. Epub 2014 Oct 3. Erratum in: Cancer. 2015 Mar 1;121(5):800. [https://doi.org/10.1002/cncr.29087 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25283774/ PubMed] [https://clinicaltrials.gov/study/NCT00841724 NCT00841724]
 +
#'''CALGB 100103:''' Devine SM, Owzar K, Blum W, Mulkey F, Stone RM, Hsu JW, Champlin RE, Chen YB, Vij R, Slack J, Soiffer RJ, Larson RA, Shea TC, Hars V, Sibley AB, Giralt S, Carter S, Horowitz MM, Linker C, Alyea EP. Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: results from Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. J Clin Oncol. 2015 Dec 10;33(35):4167-75. Epub 2015 Nov 2. [https://doi.org/10.1200/jco.2015.62.7273 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658453/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26527780/ PubMed] [https://clinicaltrials.gov/study/NCT00070135 NCT00070135]
 +
#'''MC-FludT.14/L:''' Beelen DW, Trenschel R, Stelljes M, Groth C, Masszi T, Reményi P, Wagner-Drouet EM, Hauptrock B, Dreger P, Luft T, Bethge W, Vogel W, Ciceri F, Peccatori J, Stölzel F, Schetelig J, Junghanß C, Grosse-Thie C, Michallet M, Labussiere-Wallet H, Schaefer-Eckart K, Dressler S, Grigoleit GU, Mielke S, Scheid C, Holtick U, Patriarca F, Medeot M, Rambaldi A, Micò MC, Niederwieser D, Franke GN, Hilgendorf I, Winkelmann NR, Russo D, Socié G, Peffault de Latour R, Holler E, Wolff D, Glass B, Casper J, Wulf G, Menzel H, Basara N, Bieniaszewska M, Stuhler G, Verbeek M, Grass S, Iori AP, Finke J, Benedetti F, Pichlmeier U, Hemmelmann C, Tribanek M, Klein A, Mylius HA, Baumgart J, Dzierzak-Mietla M, Markiewicz M. Treosulfan or busulfan plus fludarabine as conditioning treatment before allogeneic haemopoietic stem cell transplantation for older patients with acute myeloid leukaemia or myelodysplastic syndrome (MC-FludT.14/L): a randomised, non-inferiority, phase 3 trial. Lancet Haematol. 2020 Jan;7(1):e28-e39. Epub 2019 Oct 9. [https://doi.org/10.1016/S2352-3026(19)30157-7 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/31606445/ PubMed] [https://clinicaltrials.gov/study/NCT00822393 NCT00822393]
 +
#'''CUTALLO:''' de Masson A, Beylot-Barry M, Ram-Wolff C, Mear JB, Dalle S, d'Incan M, Ingen-Housz-Oro S, Orvain C, Abraham J, Dereure O, Charbonnier A, Cornillon J, Longvert C, Barete S, Boulinguez S, Wierzbicka-Hainaut E, Aubin F, Rubio MT, Bernard M, Schmidt-Tanguy A, Houot R, Pham-Ledard A, Michonneau D, Brice P, Labussière-Wallet H, Bouaziz JD, Grange F, Moins-Teisserenc H, Jondeau K, Michel L, Mourah S, Battistella M, Daguindau E, Loschi M, Picard A, Franck N, Maillard N, Huynh A, Nguyen S, Marçais A, Chaby G, Ceballos P, Le Corre Y, Maury S, Bay JO, Adamski H, Bachy E, Forcade E, Socié G, Bagot M, Chevret S, Peffault de Latour R; CUTALLO Investigators; Groupe Français d'Etude des Lymphomes Cutanés; Société Française de Greffe de Moëlle et Thérapie Cellulaire. Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023 Jun 10;401(10392):1941-1950. Epub 2023 Apr 24. [https://doi.org/10.1016/s0140-6736(23)00329-x link to original article] '''contains dosing details in supplement''' [https://pubmed.ncbi.nlm.nih.gov/37105210/ PubMed] [https://clinicaltrials.gov/study/NCT02520908 NCT02520908]
 +
 +
==Busulfan, Fludarabine, Ibritumomab tiuxetan {{#subobject:68bee2|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:822e5a|Variant=1}}===
 +
{| class="wikitable" style="width: 40%; text-align:center;"
 +
! style="width: 25%" |Study
 +
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://doi.org/10.1093/annonc/mdu503 Bouabdallah et al. 2015 (ZEVALLO)]
 +
| style="background-color:#91cf61" |Phase 2
 +
|-
 +
|}
 +
<section begin="822e5a" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2
 +
*[[Busulfan (Myleran)]] 3.2 mg/kg/day (route not specified) on days -5 & -4
 +
====Targeted therapy====
 +
*[[Rituximab (Rituxan)]] 250 mg/m<sup>2</sup> IV once per day on days -21 & -14
 +
====Radioconjugate therapy====
 +
*[[Ibritumomab tiuxetan (Zevalin)]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2.5 mg/kg IV once on day -1
 +
*[[Cyclosporine]] (dose not specified) until day +90 and tapered off by day +180 based on chimerism and GVHD
 +
*[[Methotrexate (MTX)]] by the following donor-based criteria:
 +
**Unrelated donors with HLA mismatch: 15 mg/m<sup>2</sup> (route not specified) once on day +1, then 10 mg/m<sup>2</sup> (route not specified) once per day on days +3 & +6
 +
'''One course'''
 +
</div>
 +
<section end="822e5a" />
 +
</div>
 +
===References===
 +
#'''ZEVALLO:''' Bouabdallah K, Furst S, Asselineau J, Chevalier P, Tournilhac O, Ceballos P, Vigouroux S, Tabrizi R, Doussau A, Bouabdallah R, Mohty M, Le Gouill S, Blaise D, Milpied N. 90Y-ibritumomab tiuxetan, fludarabine, busulfan and antithymocyte globulin reduced-intensity allogeneic transplant conditioning for patients with advanced and high-risk B-cell lymphomas. Ann Oncol. 2015 Jan;26(1):193-8. Epub 2014 Oct 30. [https://doi.org/10.1093/annonc/mdu503 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25361987/ PubMed] [https://clinicaltrials.gov/study/NCT00607854 NCT00607854]
 +
 +
==Busulfan, Fludarabine, Thiotepa {{#subobject:97rrf0|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:iyrc24|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 +
!style="width: 20%"|Study
 +
!style="width: 20%"|Dates of enrollment
 +
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 20%"|Comparator
 +
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
|-
 +
|[https://doi.org/10.1016/s0140-6736(23)00329-x de Masson et al. 2023 (CUTALLO)]
 +
|2016-06-01 to 2022-03-03
 +
| style="background-color:#1a9851" |Propensity score analysis (E-esc)
 +
|No transplant
 +
| style="background-color:#1a9850" |Superior PFS (primary endpoint)<br>Median PFS: 9 vs 3 mo<br>(HR 0.38, 95% CI 0.21-0.69)
 +
|-
 +
|}
 +
'''Diseases Studied: [[Cutaneous T-cell lymphoma]]'''
 +
<section begin="iyrc24" />
 +
''Note: this preparative regimen was intended for haploidentical HSCT.''
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 50 mg/m<sup>2</sup> IV once per day for 3 days (days not specified)
 +
*[[Busulfan (Myleran)]] 3.2 mg/kg/day IV for 3 days (days not specified)
 +
*[[Thiotepa (Tepadina)]] 5 mg/kg IV once (day not specified)
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 +
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once per day on days +3 & +5
 +
*[[Cyclosporine]] started on day -1, tapered on day +90 if no GVHD
 +
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg PO three times per day until day +35
 +
'''One course'''
 +
</div>
 +
<section end="iyrc24" />
 +
</div>
 +
===References===
 +
#'''CUTALLO:''' de Masson A, Beylot-Barry M, Ram-Wolff C, Mear JB, Dalle S, d'Incan M, Ingen-Housz-Oro S, Orvain C, Abraham J, Dereure O, Charbonnier A, Cornillon J, Longvert C, Barete S, Boulinguez S, Wierzbicka-Hainaut E, Aubin F, Rubio MT, Bernard M, Schmidt-Tanguy A, Houot R, Pham-Ledard A, Michonneau D, Brice P, Labussière-Wallet H, Bouaziz JD, Grange F, Moins-Teisserenc H, Jondeau K, Michel L, Mourah S, Battistella M, Daguindau E, Loschi M, Picard A, Franck N, Maillard N, Huynh A, Nguyen S, Marçais A, Chaby G, Ceballos P, Le Corre Y, Maury S, Bay JO, Adamski H, Bachy E, Forcade E, Socié G, Bagot M, Chevret S, Peffault de Latour R; CUTALLO Investigators; Groupe Français d'Etude des Lymphomes Cutanés; Société Française de Greffe de Moëlle et Thérapie Cellulaire. Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023 Jun 10;401(10392):1941-1950. Epub 2023 Apr 24. [https://doi.org/10.1016/s0140-6736(23)00329-x link to original article] '''contains dosing details in supplement''' [https://pubmed.ncbi.nlm.nih.gov/37105210/ PubMed] [https://clinicaltrials.gov/study/NCT02520908 NCT02520908]
  
#'''CALGB 100103:''' Devine SM, Owzar K, Blum W, Mulkey F, Stone RM, Hsu JW, Champlin RE, Chen YB, Vij R, Slack J, Soiffer RJ, Larson RA, Shea TC, Hars V, Sibley AB, Giralt S, Carter S, Horowitz MM, Linker C, Alyea EP. Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: results from Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. J Clin Oncol. 2015 Dec 10;33(35):4167-75. Epub 2015 Nov 2. [https://doi.org/10.1200/jco.2015.62.7273 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658453/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26527780 PubMed] NCT00070135
 
#'''MC-FludT.14/L:''' Beelen DW, Trenschel R, Stelljes M, Groth C, Masszi T, Reményi P, Wagner-Drouet EM, Hauptrock B, Dreger P, Luft T, Bethge W, Vogel W, Ciceri F, Peccatori J, Stölzel F, Schetelig J, Junghanß C, Grosse-Thie C, Michallet M, Labussiere-Wallet H, Schaefer-Eckart K, Dressler S, Grigoleit GU, Mielke S, Scheid C, Holtick U, Patriarca F, Medeot M, Rambaldi A, Micò MC, Niederwieser D, Franke GN, Hilgendorf I, Winkelmann NR, Russo D, Socié G, Peffault de Latour R, Holler E, Wolff D, Glass B, Casper J, Wulf G, Menzel H, Basara N, Bieniaszewska M, Stuhler G, Verbeek M, Grass S, Iori AP, Finke J, Benedetti F, Pichlmeier U, Hemmelmann C, Tribanek M, Klein A, Mylius HA, Baumgart J, Dzierzak-Mietla M, Markiewicz M. Treosulfan or busulfan plus fludarabine as conditioning treatment before allogeneic haemopoietic stem cell transplantation for older patients with acute myeloid leukaemia or myelodysplastic syndrome (MC-FludT.14/L): a randomised, non-inferiority, phase 3 trial. Lancet Haematol. 2020 Jan;7(1):e28-e39. Epub 2019 Oct 9. [https://doi.org/10.1016/S2352-3026(19)30157-7 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/31606445 PubMed] NCT00822393
 
 
==Clofarabine & Melphalan {{#subobject:08947a|Regimen=1}}==
 
==Clofarabine & Melphalan {{#subobject:08947a|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
Line 725: Line 1,117:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on unspecified day
 
*[[Allogeneic stem cells]] transfused on unspecified day
 +
'''One course'''
 
</div>
 
</div>
 
<section end="a408ed" />
 
<section end="a408ed" />
 
</div>
 
</div>
 
===References===
 
===References===
#'''BRIDGE:''' Middeke JM, Herbst R, Parmentier S, Bug G, Hänel M, Stuhler G, Schäfer-Eckart K, Rösler W, Klein S, Bethge W, Bitz U, Büttner B, Knoth H, Alakel N, Schaich M, Morgner A, Kramer M, Sockel K, von Bonin M, Stölzel F, Platzbecker U, Röllig C, Thiede C, Ehninger G, Bornhäuser M, Schetelig J. Clofarabine salvage therapy before allogeneic hematopoietic stem cell transplantation in patients with relapsed or refractory AML: results of the BRIDGE trial. Leukemia. 2016 Feb;30(2):261-7. Epub 2015 Aug 18. [https://doi.org/10.1038/leu.2015.226 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/26283567 PubMed]
+
#'''BRIDGE:''' Middeke JM, Herbst R, Parmentier S, Bug G, Hänel M, Stuhler G, Schäfer-Eckart K, Rösler W, Klein S, Bethge W, Bitz U, Büttner B, Knoth H, Alakel N, Schaich M, Morgner A, Kramer M, Sockel K, von Bonin M, Stölzel F, Platzbecker U, Röllig C, Thiede C, Ehninger G, Bornhäuser M, Schetelig J. Clofarabine salvage therapy before allogeneic hematopoietic stem cell transplantation in patients with relapsed or refractory AML: results of the BRIDGE trial. Leukemia. 2016 Feb;30(2):261-7. Epub 2015 Aug 18. [https://doi.org/10.1038/leu.2015.226 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/26283567/ PubMed]
 
==Cyclophosphamide, Fludarabine, Thiotepa {{#subobject:ee93e3|Regimen=1}}==
 
==Cyclophosphamide, Fludarabine, Thiotepa {{#subobject:ee93e3|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
Line 737: Line 1,130:
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[http://www.bloodjournal.org/content/99/1/75.long Corradini et al. 2002]
+
|[https://doi.org/10.1182/blood.V99.1.75 Corradini et al. 2002]
 
| style="background-color:#91cf61" |Non-randomized
 
| style="background-color:#91cf61" |Non-randomized
 
|-
 
|-
 
|}
 
|}
Details to be completed.
 
 
<section begin="81245f" />
 
<section begin="81245f" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
*[[Cyclophosphamide (Cytoxan)]]
+
*[[Cyclophosphamide (Cytoxan)]] 30 mg/kg IV once per day on days -4 & -3
*[[Fludarabine (Fludara)]]
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -4 & -3, given 4 hours after cyclophosphamide
*[[Thiotepa (Thioplex)]]
+
*[[Thiotepa (Thioplex)]] by the following age-based criteria:
 +
**Younger than 45 years old: 7.5 mg/kg IV once every 12 hours on day -6 (total dose 15 mg/kg)
 +
**45 to 60 years old: 5 mg/kg IV once every 12 hours on day -6 (total dose 10 mg/kg)
 +
**Older than 60 years old: 2.5 mg/kg IV once every 12 hours on day -6 (total dose 5 mg/kg)
 
====Immunotherapy====
 
====Immunotherapy====
*[[Allogeneic stem cells]]
+
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="81245f" />
 
<section end="81245f" />
 
</div>
 
</div>
 
===References===
 
===References===
#Corradini P, Tarella C, Olivieri A, Gianni AM, Voena C, Zallio F, Ladetto M, Falda M, Lucesole M, Dodero A, Ciceri F, Benedetti F, Rambaldi A, Sajeva MR, Tresoldi M, Pileri A, Bordignon C, Bregni M. Reduced-intensity conditioning followed by allografting of hematopoietic cells can produce clinical and molecular remissions in patients with poor-risk hematologic malignancies. Blood. 2002 Jan 1;99(1):75-82. [http://www.bloodjournal.org/content/99/1/75.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/11756155 PubMed]
+
#Corradini P, Tarella C, Olivieri A, Gianni AM, Voena C, Zallio F, Ladetto M, Falda M, Lucesole M, Dodero A, Ciceri F, Benedetti F, Rambaldi A, Sajeva MR, Tresoldi M, Pileri A, Bordignon C, Bregni M. Reduced-intensity conditioning followed by allografting of hematopoietic cells can produce clinical and molecular remissions in patients with poor-risk hematologic malignancies. Blood. 2002 Jan 1;99(1):75-82. [https://doi.org/10.1182/blood.V99.1.75 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/11756155/ PubMed]
==FC {{#subobject:1a1ed9|Regimen=1}}==
+
 
 +
==Cyclophosphamide & Fludarabine (FC) {{#subobject:1a1ed9|Regimen=1}}==
 
FC: '''<u>F</u>'''ludarabine & '''<u>C</u>'''yclophosphamide
 
FC: '''<u>F</u>'''ludarabine & '''<u>C</u>'''yclophosphamide
 +
<br>FluCy: '''<u>Flu</u>'''darabine & '''<u>Cy</u>'''clophosphamide
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #1, BSA-based Cy {{#subobject:886e40|Variant=1}}===
+
===Regimen variant #1, 150/2500 {{#subobject:886e40|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |Study
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[http://www.bloodjournal.org/content/116/14/2438 Dreger et al. 2010 (GCLLSG CLL3X)]
+
|[https://doi.org/10.1182/blood-2010-03-275420 Dreger et al. 2010 (GCLLSG CLL3X)]
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
 
|}
 
|}
''This regimen is intended for related donors.''
 
 
<section begin="886e40" />
 
<section begin="886e40" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2
+
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days -6 to -2
+
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
 +
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius]] by the following donor-based criteria:
 +
**Unrelated donors: 10 mg/kg/day IV on days -4 to -1 (4 consecutive days)
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="886e40" />
 
<section end="886e40" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #2, weight-based Cy {{#subobject:9ce8f1|Variant=1}}===
+
===Regimen variant #2, 125/120 {{#subobject:9ce8f1|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |Study
Line 785: Line 1,186:
 
|-
 
|-
 
|[https://doi.org/10.1056/NEJM200009143431101 Childs et al. 2000]
 
|[https://doi.org/10.1056/NEJM200009143431101 Childs et al. 2000]
| style="background-color:#ffffbe" |Non-randomized, <20 pts
+
| style="background-color:#ffffbe" |Non-randomized, fewer than 20 pts
 
|-
 
|-
 
|}
 
|}
Line 795: Line 1,196:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="9ce8f1" />
 
<section end="9ce8f1" />
 
</div>
 
</div>
 
===References===
 
===References===
#Childs R, Chernoff A, Contentin N, Bahceci E, Schrump D, Leitman S, Read EJ, Tisdale J, Dunbar C, Linehan WM, Young NS, Clave E, Epperson D, Mayo V, Barrett AJ. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med. 2000 Sep 14;343(11):750-8. [https://doi.org/10.1056/NEJM200009143431101 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/10984562 PubMed]
+
#Childs R, Chernoff A, Contentin N, Bahceci E, Schrump D, Leitman S, Read EJ, Tisdale J, Dunbar C, Linehan WM, Young NS, Clave E, Epperson D, Mayo V, Barrett AJ. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med. 2000 Sep 14;343(11):750-8. [https://doi.org/10.1056/NEJM200009143431101 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/10984562/ PubMed]
#'''GCLLSG CLL3X:''' Dreger P, Döhner H, Ritgen M, Böttcher S, Busch R, Dietrich S, Bunjes D, Cohen S, Schubert J, Hegenbart U, Beelen D, Zeis M, Stadler M, Hasenkamp J, Uharek L, Scheid C, Humpe A, Zenz T, Winkler D, Hallek M, Kneba M, Schmitz N, Stilgenbauer S; German CLL Study Group. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood. 2010 Oct 7;116(14):2438-47. Epub 2010 Jul 1. [http://www.bloodjournal.org/content/116/14/2438 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/20595516 PubMed] NCT00281983
+
#'''GCLLSG CLL3X:''' Dreger P, Döhner H, Ritgen M, Böttcher S, Busch R, Dietrich S, Bunjes D, Cohen S, Schubert J, Hegenbart U, Beelen D, Zeis M, Stadler M, Hasenkamp J, Uharek L, Scheid C, Humpe A, Zenz T, Winkler D, Hallek M, Kneba M, Schmitz N, Stilgenbauer S; German CLL Study Group. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood. 2010 Oct 7;116(14):2438-47. Epub 2010 Jul 1. [https://doi.org/10.1182/blood-2010-03-275420 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/20595516/ PubMed] [https://clinicaltrials.gov/study/NCT00281983 NCT00281983]
##'''Update:''' Dreger P, Schnaiter A, Zenz T, Böttcher S, Rossi M, Paschka P, Bühler A, Dietrich S, Busch R, Ritgen M, Bunjes D, Zeis M, Stadler M, Uharek L, Scheid C, Hegenbart U, Hallek M, Kneba M, Schmitz N, Döhner H, Stilgenbauer S. TP53, SF3B1, and NOTCH1 mutations and outcome of allotransplantation for chronic lymphocytic leukemia: six-year follow-up of the GCLLSG CLL3X trial. Blood. 2013 Apr 18;121(16):3284-8. Epub 2013 Feb 22. [http://www.bloodjournal.org/content/121/16/3284.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/23435461 PubMed]
+
##'''Update:''' Dreger P, Schnaiter A, Zenz T, Böttcher S, Rossi M, Paschka P, Bühler A, Dietrich S, Busch R, Ritgen M, Bunjes D, Zeis M, Stadler M, Uharek L, Scheid C, Hegenbart U, Hallek M, Kneba M, Schmitz N, Döhner H, Stilgenbauer S. TP53, SF3B1, and NOTCH1 mutations and outcome of allotransplantation for chronic lymphocytic leukemia: six-year follow-up of the GCLLSG CLL3X trial. Blood. 2013 Apr 18;121(16):3284-8. Epub 2013 Feb 22. [https://doi.org/10.1182/blood-2012-11-469627 link to original article] [https://pubmed.ncbi.nlm.nih.gov/23435461/ PubMed]
##'''Update:''' Krämer I, Stilgenbauer S, Dietrich S, Böttcher S, Zeis M, Stadler M, Bittenbring J, Uharek L, Scheid C, Hegenbart U, Ho A, Hallek M, Kneba M, Schmitz N, Döhner H, Dreger P. Allogeneic hematopoietic cell transplantation for high-risk CLL: 10-year follow-up of the GCLLSG CLL3X trial. Blood. 2017 Sep 21;130(12):1477-1480. Epub 2017 Jul 17. [http://www.bloodjournal.org/content/130/12/1477.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/28716861 PubMed]
+
##'''Update:''' Krämer I, Stilgenbauer S, Dietrich S, Böttcher S, Zeis M, Stadler M, Bittenbring J, Uharek L, Scheid C, Hegenbart U, Ho A, Hallek M, Kneba M, Schmitz N, Döhner H, Dreger P. Allogeneic hematopoietic cell transplantation for high-risk CLL: 10-year follow-up of the GCLLSG CLL3X trial. Blood. 2017 Sep 21;130(12):1477-1480. Epub 2017 Jul 17. [https://doi.org/10.1182/blood-2017-04-775841 link to original article] [https://pubmed.ncbi.nlm.nih.gov/28716861/ PubMed]
 +
 
 
==FBM {{#subobject:1hg71a|Regimen=1}}==
 
==FBM {{#subobject:1hg71a|Regimen=1}}==
 
FBM: '''<u>F</u>'''ludarabine, '''<u>B</u>'''CNU (Carmustine), '''<u>M</u>'''elphalan
 
FBM: '''<u>F</u>'''ludarabine, '''<u>B</u>'''CNU (Carmustine), '''<u>M</u>'''elphalan
Line 809: Line 1,212:
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
!style="width: 33%"|Study
 
!style="width: 33%"|Study
!style="width: 33%"|Years of enrollment
+
!style="width: 33%"|Dates of enrollment
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
Line 825: Line 1,228:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div></div><br>
 
</div></div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
Line 830: Line 1,234:
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
!style="width: 33%"|Study
 
!style="width: 33%"|Study
!style="width: 33%"|Years of enrollment
+
!style="width: 33%"|Dates of enrollment
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
Line 846: Line 1,250:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div></div>
 
</div></div>
 
===References===
 
===References===
Line 853: Line 1,258:
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:4f0684|Variant=1}}===
 
===Regimen {{#subobject:4f0684|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[http://www.bloodjournal.org/content/98/13/3595.long Khouri et al. 2001 (MDACC ID01-233)]
+
|[https://doi.org/10.1182/blood.V98.13.3595 Khouri et al. 2001 (MDACC ID01-233)]
 +
|1997-2000
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
Line 872: Line 1,279:
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
*[[Antithymocyte globulin, horse ATG (Atgam)]] by the following criteria:
+
*[[Antithymocyte globulin, horse ATG (Atgam)]] by the following donor-based criteria:
 
**Matched unrelated donor: 15 mg/kg IV once per day on days -5 to -3
 
**Matched unrelated donor: 15 mg/kg IV once per day on days -5 to -3
 
*[[Tacrolimus (Prograf)]] adjusted to level of 5 to 10 ng/mL for 6 months in patients in remission
 
*[[Tacrolimus (Prograf)]] adjusted to level of 5 to 10 ng/mL for 6 months in patients in remission
*[[Methotrexate (MTX)]] by the following criteria:
+
*[[Methotrexate (MTX)]] by the following donor-based criteria:
 
**Related donors: 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6
 
**Related donors: 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6
 
**Unrelated donors: 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 
**Unrelated donors: 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 +
'''One course'''
 
</div>
 
</div>
 
<section end="4f0684" />
 
<section end="4f0684" />
 
</div>
 
</div>
 
===References===
 
===References===
#'''MDACC ID01-233:''' Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. [http://www.bloodjournal.org/content/98/13/3595.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/11739162 PubMed] NCT00048737
+
#'''MDACC ID01-233:''' Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. [https://doi.org/10.1182/blood.V98.13.3595 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11739162/ PubMed] [https://clinicaltrials.gov/study/NCT00048737 NCT00048737]
##'''Update:''' Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. [http://www.bloodjournal.org/content/111/12/5530.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624452/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18411419 PubMed]
+
##'''Update:''' Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. [https://doi.org/10.1182/blood-2008-01-136242 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624452/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18411419/ PubMed]
##'''Update:''' Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. [http://www.bloodjournal.org/content/119/26/6373.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347306/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/22586182 PubMed]
+
##'''Update:''' Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. [https://doi.org/10.1182/blood-2012-03-417808 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347306/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/22586182/ PubMed]
 
==Fludarabine & TBI {{#subobject:53c6af|Regimen=1}}==
 
==Fludarabine & TBI {{#subobject:53c6af|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
Line 890: Line 1,298:
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 17%"|Study
 
!style="width: 17%"|Study
!style="width: 15%"|Years of enrollment
+
!style="width: 15%"|Dates of enrollment
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|Comparator
 
!style="width: 17%"|Comparator
Line 909: Line 1,317:
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -3
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -3
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy fractions x 4 doses on days -3 & -2 (8 Gy total)
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy fractions x 4 doses on days -3 & -2 (800 cGy total)
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="be3609" />
 
<section end="be3609" />
Line 919: Line 1,328:
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Study
!style="width: 20%"|Years of enrollment
+
!style="width: 20%"|Dates of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|Comparator
Line 944: Line 1,353:
 
|[https://doi.org/10.1200/jco.2010.32.7312 Björkstrand et al. 2011 (EBMT-NMAM2000)]
 
|[https://doi.org/10.1200/jco.2010.32.7312 Björkstrand et al. 2011 (EBMT-NMAM2000)]
 
|2001-2005
 
|2001-2005
| style="background-color:#91cf61" |Non-randomized portion of RCT
+
| style="background-color:#91cf61" |Non-randomized part of RCT
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
 
| style="background-color:#d3d3d3" |
Line 952: Line 1,361:
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
|[[#Low-dose_TBI|Low-dose TBI]]
 
|[[#Low-dose_TBI|Low-dose TBI]]
| style="background-color:#d9ef8b" |Might have superior OS
+
| style="background-color:#d9ef8b" |Might have superior OS36 (primary endpoint)
 
|-
 
|-
 
|}
 
|}
Line 961: Line 1,370:
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -4 to -2
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -4 to -2
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 2 Gy at a rate of 0.07 Gy/min on day 0
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy at a rate of 7 cGy/min on day 0
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
Line 967: Line 1,376:
 
*[[Cyclosporine]] 6.25 mg/kg PO twice per day starting 4 to 6 hours after transplant, tapered at day 100 over 80 days (if no GVHD)
 
*[[Cyclosporine]] 6.25 mg/kg PO twice per day starting 4 to 6 hours after transplant, tapered at day 100 over 80 days (if no GVHD)
 
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg PO twice per day starting 4 to 6 hours after transplant, tapered at day 40 over 56 days (if no GVHD)
 
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg PO twice per day starting 4 to 6 hours after transplant, tapered at day 40 over 56 days (if no GVHD)
 +
'''One course'''
 
</div>
 
</div>
 
<section end="7fa6ce" />
 
<section end="7fa6ce" />
 
</div>
 
</div>
 
===References===
 
===References===
#Maris MB, Niederwieser D, Sandmaier BM, Storer B, Stuart M, Maloney D, Petersdorf E, McSweeney P, Pulsipher M, Woolfrey A, Chauncey T, Agura E, Heimfeld S, Slattery J, Hegenbart U, Anasetti C, Blume K, Storb R. HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies. Blood. 2003 Sep 15;102(6):2021-30. Epub 2003 Jun 5. [http://www.bloodjournal.org/content/102/6/2021.full link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12791654 PubMed]
+
#Maris MB, Niederwieser D, Sandmaier BM, Storer B, Stuart M, Maloney D, Petersdorf E, McSweeney P, Pulsipher M, Woolfrey A, Chauncey T, Agura E, Heimfeld S, Slattery J, Hegenbart U, Anasetti C, Blume K, Storb R. HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies. Blood. 2003 Sep 15;102(6):2021-30. Epub 2003 Jun 5. [http://www.bloodjournal.org/content/102/6/2021.full link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12791654/ PubMed]
#Sorror ML, Maris MB, Sandmaier BM, Storer BE, Stuart MJ, Hegenbart U, Agura E, Chauncey TR, Leis J, Pulsipher M, McSweeney P, Radich JP, Bredeson C, Bruno B, Langston A, Loken MR, Al-Ali H, Blume KG, Storb R, Maloney DG. Hematopoietic cell transplantation after nonmyeloablative conditioning for advanced chronic lymphocytic leukemia. J Clin Oncol. 2005 Jun 1;23(16):3819-29. Epub 2005 Apr 4. [https://doi.org/10.1200/jco.2005.04.569 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15809448 PubMed]
+
#Sorror ML, Maris MB, Sandmaier BM, Storer BE, Stuart MJ, Hegenbart U, Agura E, Chauncey TR, Leis J, Pulsipher M, McSweeney P, Radich JP, Bredeson C, Bruno B, Langston A, Loken MR, Al-Ali H, Blume KG, Storb R, Maloney DG. Hematopoietic cell transplantation after nonmyeloablative conditioning for advanced chronic lymphocytic leukemia. J Clin Oncol. 2005 Jun 1;23(16):3819-29. Epub 2005 Apr 4. [https://doi.org/10.1200/jco.2005.04.569 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15809448/ PubMed]
##'''Update:''' Sorror ML, Storer BE, Sandmaier BM, Maris M, Shizuru J, Maziarz R, Agura E, Chauncey TR, Pulsipher MA, McSweeney PA, Wade JC, Bruno B, Langston A, Radich J, Niederwieser D, Blume KG, Storb R, Maloney DG. Five-year follow-up of patients with advanced chronic lymphocytic leukemia treated with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. J Clin Oncol. 2008 Oct 20;26(30):4912-20. Epub 2008 Sep 15. [https://doi.org/10.1200/jco.2007.15.4757 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652085/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18794548 PubMed]
+
##'''Update:''' Sorror ML, Storer BE, Sandmaier BM, Maris M, Shizuru J, Maziarz R, Agura E, Chauncey TR, Pulsipher MA, McSweeney PA, Wade JC, Bruno B, Langston A, Radich J, Niederwieser D, Blume KG, Storb R, Maloney DG. Five-year follow-up of patients with advanced chronic lymphocytic leukemia treated with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. J Clin Oncol. 2008 Oct 20;26(30):4912-20. Epub 2008 Sep 15. [https://doi.org/10.1200/jco.2007.15.4757 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652085/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18794548/ PubMed]
#Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. Epub 2010 May 3. [https://doi.org/10.1200/jco.2009.27.1460 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903320/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20439626 PubMed]
+
#Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. Epub 2010 May 3. [https://doi.org/10.1200/jco.2009.27.1460 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903320/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20439626/ PubMed]
#'''EBMT-NMAM2000:''' Björkstrand B, Iacobelli S, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Musto P, Beksac M, Bosi A, Milone G, Corradini P, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Gahrton G. Tandem autologous/reduced-intensity conditioning allogeneic stem-cell transplantation versus autologous transplantation in myeloma: long-term follow-up. J Clin Oncol. 2011 Aug 1;29(22):3016-22. Epub 2011 Jul 5. Erratum in: J Clin Oncol. 2011 Sep 20;29(27):3721. [https://doi.org/10.1200/jco.2010.32.7312 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21730266 PubMed]
+
#'''EBMT-NMAM2000:''' Björkstrand B, Iacobelli S, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Musto P, Beksac M, Bosi A, Milone G, Corradini P, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Gahrton G. Tandem autologous/reduced-intensity conditioning allogeneic stem-cell transplantation versus autologous transplantation in myeloma: long-term follow-up. J Clin Oncol. 2011 Aug 1;29(22):3016-22. Epub 2011 Jul 5. Erratum in: J Clin Oncol. 2011 Sep 20;29(27):3721. [https://doi.org/10.1200/jco.2010.32.7312 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21730266/ PubMed]
##'''Update:''' Gahrton G, Iacobelli S, Björkstrand B, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Carella AM, Beksac M, Bosi A, Milone G, Corradini P, Schönland S, Friberg K, van Biezen A, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Garderet L, Kröger N; EBMT Chronic Malignancies Working Party Plasma Cell Disorders Subcommittee. Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: long-term results of the EBMT-NMAM2000 study. Blood. 2013 Jun 20;121(25):5055-63. Epub 2013 Mar 12. [http://www.bloodjournal.org/content/121/25/5055.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/23482933 PubMed]
+
##'''Update:''' Gahrton G, Iacobelli S, Björkstrand B, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Carella AM, Beksac M, Bosi A, Milone G, Corradini P, Schönland S, Friberg K, van Biezen A, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Garderet L, Kröger N; EBMT Chronic Malignancies Working Party Plasma Cell Disorders Subcommittee. Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: long-term results of the EBMT-NMAM2000 study. Blood. 2013 Jun 20;121(25):5055-63. Epub 2013 Mar 12. [http://www.bloodjournal.org/content/121/25/5055.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/23482933/ PubMed]
#'''9005-2003:''' Bornhäuser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, Baurmann H, Schäfer-Eckart K, Holler E, Kröger N, Schmid C, Einsele H, Kiehl MG, Hiddemann W, Schwerdtfeger R, Buchholz S, Dreger P, Neubauer A, Berdel WE, Ehninger G, Beelen DW, Schetelig J, Stelljes M. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012 Oct;13(10):1035-44. Epub 2012 Sep 7. [https://doi.org/10.1016/S1470-2045(12)70349-2 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22959335 PubMed] NCT00150878
+
#'''9005-2003:''' Bornhäuser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, Baurmann H, Schäfer-Eckart K, Holler E, Kröger N, Schmid C, Einsele H, Kiehl MG, Hiddemann W, Schwerdtfeger R, Buchholz S, Dreger P, Neubauer A, Berdel WE, Ehninger G, Beelen DW, Schetelig J, Stelljes M. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012 Oct;13(10):1035-44. Epub 2012 Sep 7. [https://doi.org/10.1016/S1470-2045(12)70349-2 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22959335/ PubMed] [https://clinicaltrials.gov/study/NCT00150878 NCT00150878]
#'''FHCRC 1813.00:''' Kornblit B, Maloney DG, Storb R, Storek J, Hari P, Vucinic V, Maziarz RT, Chauncey TR, Pulsipher MA, Bruno B, Petersen FB, Bethge WA, Hübel K, Bouvier ME, Fukuda T, Storer BE, Sandmaier BM. Fludarabine and 2-Gy TBI is superior to 2 Gy TBI as conditioning for HLA-matched related hematopoietic cell transplantation: a phase III randomized trial. Biol Blood Marrow Transplant. 2013 Sep;19(9):1340-7. Epub 2013 Jun 11. [https://doi.org/10.1016/j.bbmt.2013.06.002 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755028/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23769990 PubMed] NCT00075478
+
#'''FHCRC 1813.00:''' Kornblit B, Maloney DG, Storb R, Storek J, Hari P, Vucinic V, Maziarz RT, Chauncey TR, Pulsipher MA, Bruno B, Petersen FB, Bethge WA, Hübel K, Bouvier ME, Fukuda T, Storer BE, Sandmaier BM. Fludarabine and 2-Gy TBI is superior to 2 Gy TBI as conditioning for HLA-matched related hematopoietic cell transplantation: a phase III randomized trial. Biol Blood Marrow Transplant. 2013 Sep;19(9):1340-7. Epub 2013 Jun 11. [https://doi.org/10.1016/j.bbmt.2013.06.002 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755028/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23769990/ PubMed] [https://clinicaltrials.gov/study/NCT00075478 NCT00075478]
==Fludarabine, Busulfan, ATG {{#subobject:ed545b|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #1 {{#subobject:dd1486|Variant=1}}===
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
!style="width: 33%"|Study
 
!style="width: 33%"|Years of enrollment
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658453/ Devine et al. 2015 (CALGB 100103)]
 
|2004-2011
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|}
 
''This regimen is meant for all types of donors.''
 
<section begin="dd1486" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV over 30 minutes once per day on days -7 to -3
 
*[[Busulfan (Myleran)]] 0.8 mg/kg IV over 2 hours every 6 hours on days -4 & -3 (total dose: 6.4 mg/kg)
 
====Immunosuppressive therapy====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)|ATG (Rabbit)]] 2.5 mg/kg IV over 6 hours once per day on days -4 to -2
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
*[[Tacrolimus (Prograf)]] with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
 
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 
</div>
 
<section end="dd1486" />
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #2 {{#subobject:335733|Variant=1}}===
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
!style="width: 33%"|Study
 
!style="width: 33%"|Years of enrollment
 
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|[https://doi.org/10.1002/cncr.29087 Mohty et al. 2014 (ITT 08-01)]
 
|2009-2011
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|}
 
<section begin="335733" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup>/day (route not specified) on days -6 to -2
 
*[[Busulfan (Myleran)]] 130 mg/m<sup>2</sup> IV over 3 hours once per day on days -5 to -3
 
====Immunosuppressive therapy====
 
*[[:Category:Antithymocyte globulin|Antithymocyte globulin (ATG)]] (source not specified) 2.5 mg/kg/day IV on days -2 & -1
 
*As per [https://pubmed.ncbi.nlm.nih.gov/12931226 Mohty et al. 2003]
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
</div>
 
<section end="335733" />
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #3 {{#subobject:e2d51e|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|[http://www.bloodjournal.org/content/107/9/3474 Garban et al. 2006 (IFM99-03)]
 
| style="background-color:#91cf61" |Non-randomized
 
|-
 
|}
 
''This regimen was meant for patients who had an HLA-identical sibling donor, and was evaluated in multiple myeloma patients.''
 
<section begin="e2d51e" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 25 mg/m<sup>2</sup>/day (route not specified) for 5 days (days not specified)
 
*[[Busulfan (Myleran)]] 2 mg/kg<sup>2</sup> PO once per day for 2 days (days not specified)
 
====Immunosuppressive therapy====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)|ATG, rabbit (Imtix)]] 2.5 mg/kg IV over 12 hours once per day on days -5 to -1
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
*[[Cyclosporine]] with starting dose on day -1 of 3 mg/kg/day, doses adjusted to "serum levels", tapered on day +60 to off by day +100 (if no GVHD)
 
*[[Methotrexate (MTX)]] 10 mg/m<sup>2</sup> (route not specified) once per day on days +1, +3, +6
 
</div>
 
<section end="e2d51e" />
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #4 {{#subobject:e2c4bf|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|[http://www.bloodjournal.org/content/91/3/756.full Slavin et al. 1998]
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|[https://doi.org/10.1200/jco.2003.12.011 Schetelig et al. 2003]
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|}
 
<section begin="e2c4bf" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -10 to -5 (6 consecutive days)
 
*[[Busulfan (Myleran)]] 4 mg/kg/day PO on days -6 to -5 (2 consecutive days)
 
====Immunosuppressive therapy====
 
*[[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius]] 10 mg/kg IV once per day on days -4 to -1 (4 consecutive days)
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
</div>
 
<section end="e2c4bf" />
 
</div>
 
===References===
 
#Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G, Varadi G, Kirschbaum M, Ackerstein A, Samuel S, Amar A, Brautbar C, Ben-Tal O, Eldor A, Or R. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998 Feb 1;91(3):756-63. [http://www.bloodjournal.org/content/91/3/756.full link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/9446633 PubMed]
 
#Schetelig J, Thiede C, Bornhauser M, Schwerdtfeger R, Kiehl M, Beyer J, Sayer HG, Kroger N, Hensel M, Scheffold C, Held TK, Hoffken K, Ho AD, Kienast J, Neubauer A, Zander AR, Fauser AA, Ehninger G, Siegert W; Cooperative German Transplant Study Group. Evidence of a graft-versus-leukemia effect in chronic lymphocytic leukemia after reduced-intensity conditioning and allogeneic stem-cell transplantation: the Cooperative German Transplant Study Group. J Clin Oncol. 2003 Jul 15;21(14):2747-53. [https://doi.org/10.1200/jco.2003.12.011 link to original article] '''contains reference to protocol''' [https://pubmed.ncbi.nlm.nih.gov/12860954 PubMed]
 
#'''IFM99-03:''' Garban F, Attal M, Michallet M, Hulin C, Bourhis JH, Yakoub-Agha I, Lamy T, Marit G, Maloisel F, Berthou C, Dib M, Caillot D, Deprijck B, Ketterer N, Harousseau JL, Sotto JJ, Moreau P. Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma. Blood. 2006 May 1;107(9):3474-80. Epub 2006 Jan 5. [http://www.bloodjournal.org/content/107/9/3474 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16397129 PubMed]
 
##'''Pooled update:''' Moreau P, Garban F, Attal M, Michallet M, Marit G, Hulin C, Benboubker L, Doyen C, Mohty M, Yakoub-Agha I, Leyvraz S, Casassus P, Avet-Loiseau H, Garderet L, Mathiot C, Harousseau JL; IFM. Long-term follow-up results of IFM99-03 and IFM99-04 trials comparing nonmyeloablative allotransplantation with autologous transplantation in high-risk de novo multiple myeloma. Blood. 2008 Nov 1;112(9):3914-5. [http://www.bloodjournal.org/content/112/9/3914.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/18948589 PubMed]
 
#'''ITT 08-01:''' Mohty M, Malard F, Blaise D, Milpied N, Furst S, Tabrizi R, Guillaume T, Vigouroux S, El-Cheikh J, Delaunay J, Le Gouill S, Moreau P, Labopin M, Chevallier P. Reduced-toxicity conditioning with fludarabine, once-daily intravenous busulfan, and antithymocyte globulins prior to allogeneic stem cell transplantation: results of a multicenter prospective phase 2 trial. Cancer. 2015 Feb 15;121(4):562-9. Epub 2014 Oct 3. Erratum in: Cancer. 2015 Mar 1;121(5):800. [https://doi.org/10.1002/cncr.29087 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25283774 PubMed] NCT00841724
 
#'''CALGB 100103:''' Devine SM, Owzar K, Blum W, Mulkey F, Stone RM, Hsu JW, Champlin RE, Chen YB, Vij R, Slack J, Soiffer RJ, Larson RA, Shea TC, Hars V, Sibley AB, Giralt S, Carter S, Horowitz MM, Linker C, Alyea EP. Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: results from Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. J Clin Oncol. 2015 Dec 10;33(35):4167-75. Epub 2015 Nov 2. [https://doi.org/10.1200/jco.2015.62.7273 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658453/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26527780 PubMed] NCT00070135
 
==Fludarabine, Busulfan, ATG, Ibritumomab tiuxetan {{#subobject:68bee2|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:822e5a|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|[https://doi.org/10.1093/annonc/mdu503 Bouabdallah et al. 2015 (ZEVALLO)]
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|}
 
<section begin="822e5a" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2
 
*[[Busulfan (Myleran)]] 3.2 mg/kg/day (route not specified) on days -5 & -4
 
====Targeted therapy====
 
*[[Rituximab (Rituxan)]] 250 mg/m<sup>2</sup> IV once per day on days -21 & -14
 
====Radioconjugate therapy====
 
*[[Ibritumomab tiuxetan (Zevalin)]] 0.4 mCi/kg (maximum dose of 32 mCi) IV once on day -14
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2.5 mg/kg IV once on day -1
 
*[[Cyclosporine]] (dose not specified) until day +90 and tapered off by day +180 based on chimerism and GVHD
 
*[[Methotrexate (MTX)]] by the following criteria:
 
**For unrelated donors with HLA mismatch: 15 mg/m<sup>2</sup> (route not specified) once on day +1, then 10 mg/m<sup>2</sup> (route not specified) once per day on days +3 & +6
 
</div>
 
<section end="822e5a" />
 
</div>
 
===References===
 
#'''ZEVALLO:''' Bouabdallah K, Furst S, Asselineau J, Chevalier P, Tournilhac O, Ceballos P, Vigouroux S, Tabrizi R, Doussau A, Bouabdallah R, Mohty M, Le Gouill S, Blaise D, Milpied N. 90Y-ibritumomab tiuxetan, fludarabine, busulfan and antithymocyte globulin reduced-intensity allogeneic transplant conditioning for patients with advanced and high-risk B-cell lymphomas. Ann Oncol. 2015 Jan;26(1):193-8. Epub 2014 Oct 30. [https://doi.org/10.1093/annonc/mdu503 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/25361987 PubMed] NCT00607854
 
==Fludarabine, Cyclophosphamide, ATG {{#subobject:f2ce14|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:3e71d0|Variant=1}}===
 
{| class="wikitable" style="width: 40%; text-align:center;"
 
! style="width: 25%" |Study
 
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|[http://www.bloodjournal.org/content/116/14/2438 Dreger et al. 2010 (GCLLSG CLL3X)]
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|}
 
''This regimen is intended for unrelated donors.''
 
<section begin="3e71d0" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
 
*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV once per day on days -6 to -2 (5 consecutive days)
 
====Immunosuppressive therapy====
 
*[[Antithymocyte globulin, rabbit ATG (Grafalon)|ATG-Fresenius]] 10 mg/kg/day IV on days -4 to -1 (4 consecutive days)
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
</div>
 
<section end="3e71d0" />
 
</div>
 
===References===
 
  
#'''GCLLSG CLL3X:''' Dreger P, Döhner H, Ritgen M, Böttcher S, Busch R, Dietrich S, Bunjes D, Cohen S, Schubert J, Hegenbart U, Beelen D, Zeis M, Stadler M, Hasenkamp J, Uharek L, Scheid C, Humpe A, Zenz T, Winkler D, Hallek M, Kneba M, Schmitz N, Stilgenbauer S; German CLL Study Group. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood. 2010 Oct 7;116(14):2438-47. Epub 2010 Jul 1. [http://www.bloodjournal.org/content/116/14/2438 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/20595516 PubMed] NCT00281983
 
##'''Update:''' Dreger P, Schnaiter A, Zenz T, Böttcher S, Rossi M, Paschka P, Bühler A, Dietrich S, Busch R, Ritgen M, Bunjes D, Zeis M, Stadler M, Uharek L, Scheid C, Hegenbart U, Hallek M, Kneba M, Schmitz N, Döhner H, Stilgenbauer S. TP53, SF3B1, and NOTCH1 mutations and outcome of allotransplantation for chronic lymphocytic leukemia: six-year follow-up of the GCLLSG CLL3X trial. Blood. 2013 Apr 18;121(16):3284-8. Epub 2013 Feb 22. [http://www.bloodjournal.org/content/121/16/3284.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/23435461 PubMed]
 
##'''Update:''' Krämer I, Stilgenbauer S, Dietrich S, Böttcher S, Zeis M, Stadler M, Bittenbring J, Uharek L, Scheid C, Hegenbart U, Ho A, Hallek M, Kneba M, Schmitz N, Döhner H, Dreger P. Allogeneic hematopoietic cell transplantation for high-risk CLL: 10-year follow-up of the GCLLSG CLL3X trial. Blood. 2017 Sep 21;130(12):1477-1480. Epub 2017 Jul 17. [http://www.bloodjournal.org/content/130/12/1477.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/28716861 PubMed]
 
 
==Fludarabine, Cyclophosphamide, TBI for dUCB or haploidentical transplant {{#subobject:3a1faf|Regimen=1}}==
 
==Fludarabine, Cyclophosphamide, TBI for dUCB or haploidentical transplant {{#subobject:3a1faf|Regimen=1}}==
 
dUCB: '''<u>d</u>'''ouble '''<u>U</u>'''mbilical '''<u>C</u>'''ord '''<u>B</u>'''lood
 
dUCB: '''<u>d</u>'''ouble '''<u>U</u>'''mbilical '''<u>C</u>'''ord '''<u>B</u>'''lood
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #1, dUCB transplantation {{#subobject:f5d1b1|Variant=1}}===
 
===Regimen variant #1, dUCB transplantation {{#subobject:f5d1b1|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ Brunstein et al. 2011]
+
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ Brunstein et al. 2011 (BMT CTN 0604)]
 +
|2009-01 to 2010-03
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
Line 1,170: Line 1,410:
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once on day -6
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IV once on day -6
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 2 Gy once on day -1
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy once on day -1
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====Supportive therapy====
 
====Supportive therapy====
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +1, continued until ANC greater than or equal to 2000/uL for 3 consecutive days
+
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +1, continued until ANC greater than or equal to 2000/μL for 3 consecutive days
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
*[[Mycophenolate mofetil (CellCept)]] 1000 mg (route not specified) every 8 hours for patients greater than 50 kg, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
+
*[[Mycophenolate mofetil (CellCept)]] by the following weight-based criteria:
**Patients less than 50 kg received 15 mg/kg (route not specified) every 8 hours, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
+
**More than 50 kg: 1000 mg (route not specified) every 8 hours, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
 +
**Less than 50 kg: 15 mg/kg (route not specified) every 8 hours, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
 
*[[Cyclosporine]] (route not specified) with a goal trough of 200 to 400 ng/mL (starting date not specified) until day +100. Patients without GVHD had their dose tapered by 10% each week starting on day +101, with discontinuation of cyclosporine A around day +180 to +200.
 
*[[Cyclosporine]] (route not specified) with a goal trough of 200 to 400 ng/mL (starting date not specified) until day +100. Patients without GVHD had their dose tapered by 10% each week starting on day +101, with discontinuation of cyclosporine A around day +180 to +200.
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL could be substituted for cyclosporine.
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL could be substituted for cyclosporine.
 +
'''One course'''
 
</div>
 
</div>
 
<section end="f5d1b1" />
 
<section end="f5d1b1" />
Line 1,186: Line 1,428:
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #2, Haploidentical {{#subobject:61264d|Variant=1}}===
 
===Regimen variant #2, Haploidentical {{#subobject:61264d|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ Brunstein et al. 2011]
+
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ Brunstein et al. 2011 (BMT CTN 0603)]
 +
|2009-01 to 2010-03
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
Line 1,200: Line 1,444:
 
*[[Cyclophosphamide (Cytoxan)]] 14.5 mg/kg IV once per day on days -6 and -5 (2 consecutive days)
 
*[[Cyclophosphamide (Cytoxan)]] 14.5 mg/kg IV once per day on days -6 and -5 (2 consecutive days)
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 2 Gy once on day -1
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy once on day -1
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====Supportive therapy====
 
====Supportive therapy====
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
 
*[[Mesna (Mesnex)]] (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +5, continued until ANC greater than or equal to 1000/uL for 3 consecutive days
+
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day +5, continued until ANC greater than or equal to 1000/μL for 3 consecutive days
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IBW IV over 1 to 2 hours once per day on days +3 & +4, started 60 to 72 hours after marrow infusion
 
*[[Cyclophosphamide (Cytoxan)]] 50 mg/kg IBW IV over 1 to 2 hours once per day on days +3 & +4, started 60 to 72 hours after marrow infusion
 
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg (maximum daily dose of 3000 mg; route not specified) every 8 hours, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
 
*[[Mycophenolate mofetil (CellCept)]] 15 mg/kg (maximum daily dose of 3000 mg; route not specified) every 8 hours, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180
 
*[[Tacrolimus (Prograf)]] (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180
 +
'''One course'''
 
</div>
 
</div>
 
<section end="61264d" />
 
<section end="61264d" />
 
</div>
 
</div>
 
===References===
 
===References===
#Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV; BMT CTN. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. [http://www.bloodjournal.org/content/118/2/282.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/21527516 PubMed]
+
#'''BMT CTN 0603:''' Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV; BMT CTN. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. Epub 2011 Apr 28. [http://www.bloodjournal.org/content/118/2/282.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/21527516/ PubMed] [https://clinicaltrials.gov/study/NCT00849147 NCT00849147]
 +
#'''BMT CTN 0604:''' Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV; BMT CTN. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. Epub 2011 Apr 28. [http://www.bloodjournal.org/content/118/2/282.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138683/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/21527516/ PubMed] [https://clinicaltrials.gov/study/NCT00864227 NCT00864227]
 +
#'''BMT CTN 0501:''' Wagner JE Jr, Eapen M, Carter S, Wang Y, Schultz KR, Wall DA, Bunin N, Delaney C, Haut P, Margolis D, Peres E, Verneris MR, Walters M, Horowitz MM, Kurtzberg J; Blood and Marrow Transplant Clinical Trials Network. One-unit versus two-unit cord-blood transplantation for hematologic cancers. N Engl J Med. 2014 Oct 30;371(18):1685-94. [https://doi.org/10.1056/nejmoa1405584 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4257059/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25354103/ PubMed] [https://clinicaltrials.gov/study/NCT00412360 NCT00412360]
 +
#'''BMT CTN 1101:''' Fuchs EJ, O'Donnell PV, Eapen M, Logan B, Antin JH, Dawson P, Devine S, Horowitz MM, Horwitz ME, Karanes C, Leifer E, Magenau JM, McGuirk JP, Morris LE, Rezvani AR, Jones RJ, Brunstein CG. Double unrelated umbilical cord blood vs HLA-haploidentical bone marrow transplantation: the BMT CTN 1101 trial. Blood. 2021 Jan 21;137(3):420-428. [https://doi.org/10.1182/blood.2020007535 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7819761/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/33475736/ PubMed] [https://clinicaltrials.gov/study/NCT01597778 NCT01597778]
 +
##'''QoL analysis:''' El Jurdi N, Martens MJ, Brunstein CG, O'Donnell P, Lee SJ, D'Souza A, Logan B, Hong S, Singh AK, Sandhu K, Shapiro RM, Horowitz MM, Hamilton BK. Health-Related Quality of Life in Double Umbilical Cord Blood versus Haploidentical Marrow Transplantation: A Quality of Life Analysis Report of BMT CTN 1101. Transplant Cell Ther. 2023 Jul;29(7):467.e1-467.e5. Epub 2023 Apr 22. [https://doi.org/10.1016/j.jtct.2023.04.009 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc10330136/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/37088401/ PubMed]
 +
 
 
==Fludarabine & Melphalan {{#subobject:1e26e2|Regimen=1}}==
 
==Fludarabine & Melphalan {{#subobject:1e26e2|Regimen=1}}==
 
Flu-Mel: '''<u>Flu</u>'''darabine & '''<u>Mel</u>'''phalan
 
Flu-Mel: '''<u>Flu</u>'''darabine & '''<u>Mel</u>'''phalan
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #1, 132/140 {{#subobject:efd75c|Variant=1}}===
+
===Regimen variant #1, 90/140 {{#subobject:ojnvwc|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 100%; text-align:center;"
! style="width: 25%" |Study
+
!style="width: 20%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 20%"|Dates of enrollment
 +
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 20%"|Comparator
 +
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
|-
 +
|[https://doi.org/10.1016/s0140-6736(23)00329-x de Masson et al. 2023 (CUTALLO)]
 +
|2016-06-01 to 2022-03-03
 +
| style="background-color:#1a9851" |Propensity score analysis (E-esc)
 +
|No transplant
 +
| style="background-color:#1a9850" |Superior PFS (primary endpoint)<br>Median PFS: 9 vs 3 mo<br>(HR 0.38, 95% CI 0.21-0.69)
 +
|-
 +
|}
 +
'''Diseases Studied: [[Cutaneous T-cell lymphoma]]'''
 +
<section begin="ojnvwc" />
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day for 3 days (days not specified)
 +
*[[Melphalan (Alkeran)]] 140 mg/m<sup>2</sup> IV once (day not specified)
 +
====Immunotherapy====
 +
*[[Allogeneic stem cells]] transfused on day 0
 +
====GVHD prophylaxis====
 +
*[[Cyclosporine]] started on day -1, tapered on day +90 if no GVHD
 +
*[[Methotrexate (MTX)]] 15 mg/m<sup>2</sup> IV once on day +1, then 10 mg/m<sup>2</sup> IV once per day on days +3, +6, +11
 +
'''One course'''
 +
</div>
 +
<section end="ojnvwc" />
 +
</div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen variant #2, 132/140 {{#subobject:efd75c|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238917/ Anderlini et al. 2008]
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238917/ Anderlini et al. 2008]
 +
|2001-2005
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
 
|}
 
|}
 +
'''Diseases Studied: [[Classical Hodgkin lymphoma]]'''
 
<section begin="efd75c" />
 
<section begin="efd75c" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
Line 1,232: Line 1,516:
 
*[[Fludarabine (Fludara)]] 33 mg/m<sup>2</sup> IV once per day on days -5 to -2
 
*[[Fludarabine (Fludara)]] 33 mg/m<sup>2</sup> IV once per day on days -5 to -2
 
*[[Melphalan (Alkeran)]] 70 mg/m<sup>2</sup> IV once per day on days -3 & -2
 
*[[Melphalan (Alkeran)]] 70 mg/m<sup>2</sup> IV once per day on days -3 & -2
====Immunosuppressive therapy====
 
*Recipients of stem cells from matched unrelated donors also received:
 
**[[:Category:Antithymocyte globulin|ATG]] (type not specified) 2 mg/kg IV once per day on days -4 to -2
 
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 +
*[[:Category:Antithymocyte globulin|ATG]] (type not specified) by the following donor-based criteria:
 +
**Matched unrelated donor: 2 mg/kg IV once per day on days -4 to -2
 
*[[Tacrolimus (Prograf)]] IV starting on day -2, dosed to achieve serum levels 4 to 12 ng/mL and switched to PO as soon as possible. Continued for at least 6 months and then "tapered off" (instructions not given).
 
*[[Tacrolimus (Prograf)]] IV starting on day -2, dosed to achieve serum levels 4 to 12 ng/mL and switched to PO as soon as possible. Continued for at least 6 months and then "tapered off" (instructions not given).
 
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6 (extra dose on day +11 for MUD recipients)
 
*[[Methotrexate (MTX)]] 5 mg/m<sup>2</sup> IV once per day on days +1, +3, +6 (extra dose on day +11 for MUD recipients)
 +
'''One course'''
 
</div>
 
</div>
 
<section end="efd75c" />
 
<section end="efd75c" />
 
</div><br>
 
</div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen variant #2, 150/140 {{#subobject:3239ec|Variant=1}}===
+
===Regimen variant #3, 150/140 {{#subobject:3239ec|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://doi.org/10.1016/j.bbmt.2005.09.009 Alvarez et al. 2006]
 
|[https://doi.org/10.1016/j.bbmt.2005.09.009 Alvarez et al. 2006]
 +
|1999-06 to 2004-01
 
| style="background-color:#91cf61" |Prospective
 
| style="background-color:#91cf61" |Prospective
 
|-
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269494/ Sureda et al. 2011 (HDR-ALLO)]
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269494/ Sureda et al. 2011 (HDR-ALLO)]
 +
|NR
 
| style="background-color:#91cf61" |Phase 2
 
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
 
|}
 
|}
 +
'''Diseases Studied: [[Classical Hodgkin lymphoma]]'''<br>
 +
''Note: Alvarez et al. 2006 began CsA on day -1 and did not give day +11 MTX.''
 
<section begin="3239ec" />
 
<section begin="3239ec" />
''Note: Alvarez et al. 2006 began CsA on day -1 and did not give day +11 MTX.''
 
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -8 to -4
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -8 to -4
 
*[[Melphalan (Alkeran)]] 70 mg/m<sup>2</sup> IV once per day on days -3 & -2
 
*[[Melphalan (Alkeran)]] 70 mg/m<sup>2</sup> IV once per day on days -3 & -2
====Immunosuppressive therapy====
 
*Recipients of stem cells from matched unrelated donors also received:
 
**Alvarez et al. 2006: [[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2.5 mg/kg IV once per day on days -4 to -2
 
**HDR-ALLO: [[:Category:Antithymocyte globulin|ATG]] (type not specified) 45 mg/kg IV once per day on days -4 to -2
 
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 +
*Recipients of stem cells from matched unrelated donors received:
 +
**Alvarez et al. 2006: [[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 2.5 mg/kg IV once per day on days -4 to -2
 +
**HDR-ALLO: [[:Category:Antithymocyte globulin|ATG]] (type not specified) 45 mg/kg IV once per day on days -4 to -2
 
*[[Cyclosporine]] starting on day -2 at 1.5 mg/kg IV twice per day
 
*[[Cyclosporine]] starting on day -2 at 1.5 mg/kg IV twice per day
 
**''If no acute GVHD of grade 2 or more, cyclosporine A is tapered down by 10% per week starting on day +90 with planned discontinuation by day +150 (Alvarez et al. 2006) or +180 (HDR-ALLO).''
 
**''If no acute GVHD of grade 2 or more, cyclosporine A is tapered down by 10% per week starting on day +90 with planned discontinuation by day +150 (Alvarez et al. 2006) or +180 (HDR-ALLO).''
 
*[[Methotrexate (MTX)]] 10 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 
*[[Methotrexate (MTX)]] 10 mg/m<sup>2</sup> IV once per day on days +1, +3, +6, +11
 +
'''One course'''
 
</div>
 
</div>
 
<section end="3239ec" />
 
<section end="3239ec" />
</div>
+
</div><br>
===References===
 
#Alvarez I, Sureda A, Caballero MD, Urbano-Ispizua A, Ribera JM, Canales M, García-Conde J, Sanz G, Arranz R, Bernal MT, de la Serna J, Díez JL, Moraleda JM, Rubió-Félix D, Xicoy B, Martínez C, Mateos MV, Sierra J. Nonmyeloablative stem cell transplantation is an effective therapy for refractory or relapsed Hodgkin lymphoma: results of a Spanish prospective cooperative protocol. Biol Blood Marrow Transplant. 2006 Feb;12(2):172-83. [https://doi.org/10.1016/j.bbmt.2005.09.009 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16443515 PubMed]
 
#Anderlini P, Saliba R, Acholonu S, Giralt SA, Andersson B, Ueno NT, Hosing C, Khouri IF, Couriel D, de Lima M, Qazilbash MH, Pro B, Romaguera J, Fayad L, Hagemeister F, Younes A, Munsell MF, Champlin RE. Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated MD Anderson Cancer Center experience. Haematologica. 2008 Feb;93(2):257-64. Epub 2008 Jan 26. [http://www.haematologica.org/content/93/2/257.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238917/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18223284 PubMed]
 
#'''HDR-ALLO:''' Sureda A, Canals C, Arranz R, Caballero D, Ribera JM, Brune M, Passweg J, Martino R, Valcárcel D, Besalduch J, Duarte R, León A, Pascual MJ, García-Noblejas A, López Corral L, Xicoy B, Sierra J, Schmitz N; GEL/TAMO. Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma: results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2012 Feb;97(2):310-7. Epub 2011 Oct 11. [http://www.haematologica.org/content/97/2/310.long link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269494/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/21993674 PubMed]
 
==Fludarabine, Melphalan, Alemtuzumab {{#subobject:99386e|Regimen=1}}==
 
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
===Regimen {{#subobject:149798|Variant=1}}===
+
===Regimen variant #4, 150/40, with alemtuzumab {{#subobject:149798|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://doi.org/10.1016/s0140-6736(05)66659-7 Peggs et al. 2005]
 
|[https://doi.org/10.1016/s0140-6736(05)66659-7 Peggs et al. 2005]
 +
|1997-10-3 to 2003-08-21
 
| style="background-color:#91cf61" |Non-randomized
 
| style="background-color:#91cf61" |Non-randomized
 
|-
 
|-
Line 1,297: Line 1,582:
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
====Immunosuppressive therapy====
+
====GVHD prophylaxis====
 
*[[Alemtuzumab (Campath)]]
 
*[[Alemtuzumab (Campath)]]
 +
'''One course'''
 
</div>
 
</div>
 
<section end="149798" />
 
<section end="149798" />
 
</div>
 
</div>
 
===References===
 
===References===
#Peggs KS, Hunter A, Chopra R, Parker A, Mahendra P, Milligan D, Craddock C, Pettengell R, Dogan A, Thomson KJ, Morris EC, Hale G, Waldmann H, Goldstone AH, Linch DC, Mackinnon S. Clinical evidence of a graft-versus-Hodgkin's-lymphoma effect after reduced-intensity allogeneic transplantation. Lancet. 2005 Jun 4-10;365(9475):1934-41. [https://doi.org/10.1016/s0140-6736(05)66659-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15936420 PubMed]
+
#Peggs KS, Hunter A, Chopra R, Parker A, Mahendra P, Milligan D, Craddock C, Pettengell R, Dogan A, Thomson KJ, Morris EC, Hale G, Waldmann H, Goldstone AH, Linch DC, Mackinnon S. Clinical evidence of a graft-versus-Hodgkin's-lymphoma effect after reduced-intensity allogeneic transplantation. Lancet. 2005 Jun 4-10;365(9475):1934-41. [https://doi.org/10.1016/s0140-6736(05)66659-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15936420/ PubMed]
 +
#Alvarez I, Sureda A, Caballero MD, Urbano-Ispizua A, Ribera JM, Canales M, García-Conde J, Sanz G, Arranz R, Bernal MT, de la Serna J, Díez JL, Moraleda JM, Rubió-Félix D, Xicoy B, Martínez C, Mateos MV, Sierra J. Nonmyeloablative stem cell transplantation is an effective therapy for refractory or relapsed Hodgkin lymphoma: results of a Spanish prospective cooperative protocol. Biol Blood Marrow Transplant. 2006 Feb;12(2):172-83. [https://doi.org/10.1016/j.bbmt.2005.09.009 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16443515/ PubMed]
 +
#Anderlini P, Saliba R, Acholonu S, Giralt SA, Andersson B, Ueno NT, Hosing C, Khouri IF, Couriel D, de Lima M, Qazilbash MH, Pro B, Romaguera J, Fayad L, Hagemeister F, Younes A, Munsell MF, Champlin RE. Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated MD Anderson Cancer Center experience. Haematologica. 2008 Feb;93(2):257-64. Epub 2008 Jan 26. [http://www.haematologica.org/content/93/2/257.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238917/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18223284/ PubMed]
 +
#'''HDR-ALLO:''' Sureda A, Canals C, Arranz R, Caballero D, Ribera JM, Brune M, Passweg J, Martino R, Valcárcel D, Besalduch J, Duarte R, León A, Pascual MJ, García-Noblejas A, López Corral L, Xicoy B, Sierra J, Schmitz N; GEL/TAMO. Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma: results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2012 Feb;97(2):310-7. Epub 2011 Oct 11. [http://www.haematologica.org/content/97/2/310.long link to original article] '''contains dosing details in abstract''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269494/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/21993674/ PubMed]
 +
#'''CUTALLO:''' de Masson A, Beylot-Barry M, Ram-Wolff C, Mear JB, Dalle S, d'Incan M, Ingen-Housz-Oro S, Orvain C, Abraham J, Dereure O, Charbonnier A, Cornillon J, Longvert C, Barete S, Boulinguez S, Wierzbicka-Hainaut E, Aubin F, Rubio MT, Bernard M, Schmidt-Tanguy A, Houot R, Pham-Ledard A, Michonneau D, Brice P, Labussière-Wallet H, Bouaziz JD, Grange F, Moins-Teisserenc H, Jondeau K, Michel L, Mourah S, Battistella M, Daguindau E, Loschi M, Picard A, Franck N, Maillard N, Huynh A, Nguyen S, Marçais A, Chaby G, Ceballos P, Le Corre Y, Maury S, Bay JO, Adamski H, Bachy E, Forcade E, Socié G, Bagot M, Chevret S, Peffault de Latour R; CUTALLO Investigators; Groupe Français d'Etude des Lymphomes Cutanés; Société Française de Greffe de Moëlle et Thérapie Cellulaire. Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023 Jun 10;401(10392):1941-1950. Epub 2023 Apr 24. [https://doi.org/10.1016/s0140-6736(23)00329-x link to original article] '''contains dosing details in supplement''' [https://pubmed.ncbi.nlm.nih.gov/37105210/ PubMed] [https://clinicaltrials.gov/study/NCT02520908 NCT02520908]
 
==Low-dose TBI {{#subobject:529ee7|Regimen=1}}==
 
==Low-dose TBI {{#subobject:529ee7|Regimen=1}}==
 
TBI: '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
 
TBI: '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
Line 1,319: Line 1,609:
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Radiotherapy====
 
====Radiotherapy====
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 2 Gy at a rate of 0.07 to 0.20 Gy/min on day 0
+
*[[External_beam_radiotherapy|Total body irradiation (TBI)]] 200 cGy at a rate of 0.07 to 0.2000 cGy/min on day 0
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
Line 1,327: Line 1,617:
 
**[[Tacrolimus (Prograf)]]
 
**[[Tacrolimus (Prograf)]]
 
*[[Mycophenolate mofetil (CellCept)]]
 
*[[Mycophenolate mofetil (CellCept)]]
 +
'''One course'''
 
</div>
 
</div>
 
<section end="174a8e" />
 
<section end="174a8e" />
 
</div>
 
</div>
 
===References===
 
===References===
 
+
#Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. Epub 2010 May 3. [https://doi.org/10.1200/jco.2009.27.1460 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903320/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20439626/ PubMed]
#Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. Epub 2010 May 3. [https://doi.org/10.1200/jco.2009.27.1460 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2903320/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/20439626 PubMed]
+
==TLI {{#subobject:49eb63|Regimen=1}}==
==TLI & ATG {{#subobject:49eb63|Regimen=1}}==
+
TLI: '''<u>T</u>'''otal '''<u>L</u>'''ymphocyte '''<u>I</u>'''rradiation
TLI & ATG: '''<u>T</u>'''otal '''<u>L</u>'''ymphocyte '''<u>I</u>'''rradiation & '''<u>A</u>'''nti-'''<u>T</u>'''hymocyte '''<u>G</u>'''lobulin
 
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:dad2af|Variant=1}}===
 
===Regimen {{#subobject:dad2af|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
 
|[https://doi.org/10.1056/NEJMoa050642 Lowsky et al. 2005]
 
|[https://doi.org/10.1056/NEJMoa050642 Lowsky et al. 2005]
 +
|2001-12-28 to 2004-12-01
 
| style="background-color:#91cf61" |Non-randomized
 
| style="background-color:#91cf61" |Non-randomized
 
|-
 
|-
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721787/ Kohrt et al. 2009]
+
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721787/ Kohrt et al. 2009 (BMT153)]
 +
|2001-12-28 to 2007-09-06
 
| style="background-color:#91cf61" |Non-randomized
 
| style="background-color:#91cf61" |Non-randomized
 
|-
 
|-
 
|}
 
|}
''Note: the schedule for TLI in Kohrt et al. 2009 is slightly different, although the manuscript states that the protocol from Lowsky et al. 2006 was followed. See paper for details.''
+
''Note: the schedule for TLI in BMT153 is slightly different, although the manuscript states that the protocol from Lowsky et al. 2005 was followed. See paper for details.''
 
<section begin="dad2af" />
 
<section begin="dad2af" />
 
<div class="toccolours" style="background-color:#b3e2cd">
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Radiotherapy====
 
====Radiotherapy====
 
*[[External_beam_radiotherapy|TLI]] 800 cGy once per day on days -11 to -1 (10 fractions)
 
*[[External_beam_radiotherapy|TLI]] 800 cGy once per day on days -11 to -1 (10 fractions)
====Immunosuppressive therapy====
+
====GVHD prophylaxis====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 1.5 mg/kg IV once per day on days -11 to -7
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] 1.5 mg/kg IV once per day on days -11 to -7
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 +
'''One course'''
 
</div>
 
</div>
 
<section end="dad2af" />
 
<section end="dad2af" />
 
</div>
 
</div>
 
===References===
 
===References===
#Lowsky R, Takahashi T, Liu YP, Dejbakhsh-Jones S, Grumet FC, Shizuru JA, Laport GG, Stockerl-Goldstein KE, Johnston LJ, Hoppe RT, Bloch DA, Blume KG, Negrin RS, Strober S. Protective conditioning for acute graft-versus-host disease. N Engl J Med. 2005 Sep 29;353(13):1321-31. Erratum in: N Engl J Med. 2006 Feb 23;354(8):884. [https://doi.org/10.1056/NEJMoa050642 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16192477 PubMed]
+
#Lowsky R, Takahashi T, Liu YP, Dejbakhsh-Jones S, Grumet FC, Shizuru JA, Laport GG, Stockerl-Goldstein KE, Johnston LJ, Hoppe RT, Bloch DA, Blume KG, Negrin RS, Strober S. Protective conditioning for acute graft-versus-host disease. N Engl J Med. 2005 Sep 29;353(13):1321-31. Erratum in: N Engl J Med. 2006 Feb 23;354(8):884. [https://doi.org/10.1056/NEJMoa050642 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16192477/ PubMed]
#Kohrt HE, Turnbull BB, Heydari K, Shizuru JA, Laport GG, Miklos DB, Johnston LJ, Arai S, Weng WK, Hoppe RT, Lavori PW, Blume KG, Negrin RS, Strober S, Lowsky R. TLI and ATG conditioning with low risk of graft-versus-host disease retains antitumor reactions after allogeneic hematopoietic cell transplantation from related and unrelated donors. Blood. 2009 Jul 30;114(5):1099-109. [http://www.bloodjournal.org/content/114/5/1099.long link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721787/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19423725 PubMed]
+
#'''BMT153:''' Kohrt HE, Turnbull BB, Heydari K, Shizuru JA, Laport GG, Miklos DB, Johnston LJ, Arai S, Weng WK, Hoppe RT, Lavori PW, Blume KG, Negrin RS, Strober S, Lowsky R. TLI and ATG conditioning with low risk of graft-versus-host disease retains antitumor reactions after allogeneic hematopoietic cell transplantation from related and unrelated donors. Blood. 2009 Jul 30;114(5):1099-109. Epub 2009 May 7. [http://www.bloodjournal.org/content/114/5/1099.long link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721787/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19423725/ PubMed] [https://clinicaltrials.gov/study/NCT00185640 NCT00185640]
 +
 
 
==(90)YFC {{#subobject:ed22a7|Regimen=1}}==
 
==(90)YFC {{#subobject:ed22a7|Regimen=1}}==
 
(90)YFC: Ibritumomab tiuxetan, '''<u>F</u>'''ludarabine, '''<u>C</u>'''yclophosphamide
 
(90)YFC: Ibritumomab tiuxetan, '''<u>F</u>'''ludarabine, '''<u>C</u>'''yclophosphamide
 
<div class="toccolours" style="background-color:#eeeeee">
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:efc342|Variant=1}}===
 
===Regimen {{#subobject:efc342|Variant=1}}===
{| class="wikitable" style="width: 40%; text-align:center;"
+
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
! style="width: 25%" |Study
+
!style="width: 33%"|Study
! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
+
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
|-
 
|-
|[http://www.bloodjournal.org/content/98/13/3595.long Khouri et al. 2012 (MDACC ID01-233)]
+
|[https://doi.org/10.1182/blood.V98.13.3595 Khouri et al. 2001 (MDACC ID01-233)]
| style="background-color:#91cf61" |Non-randomized
+
|1997-2000
 +
| style="background-color:#91cf61" |Phase 2
 
|-
 
|-
 
|}
 
|}
Line 1,386: Line 1,683:
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -5 to -3
 
*[[Fludarabine (Fludara)]] 30 mg/m<sup>2</sup> IV once per day on days -5 to -3
 
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once per day on days -5 to -3
 
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once per day on days -5 to -3
====Immunosuppressive therapy====
 
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] by the following criteria:
 
**Matched unrelated or mismatched donors: 1 mg/kg IV once per day on days -2 & -1
 
 
====Immunotherapy====
 
====Immunotherapy====
 
*[[Allogeneic stem cells]] transfused on day 0
 
*[[Allogeneic stem cells]] transfused on day 0
 
====GVHD prophylaxis====
 
====GVHD prophylaxis====
 +
*[[Antithymocyte globulin, rabbit ATG (Thymoglobulin)]] by the following donor-based criteria:
 +
**Matched unrelated or mismatched donors: 1 mg/kg IV once per day on days -2 & -1
 
*[[Tacrolimus (Prograf)]]
 
*[[Tacrolimus (Prograf)]]
 
*[[Methotrexate (MTX)]]
 
*[[Methotrexate (MTX)]]
 +
'''One course'''
 
</div>
 
</div>
 
<section end="efc342" />
 
<section end="efc342" />
 
</div>
 
</div>
 
===References===
 
===References===
#'''MDACC ID01-233:''' Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. [http://www.bloodjournal.org/content/98/13/3595.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/11739162 PubMed] NCT00048737
+
#'''MDACC ID01-233:''' Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. [https://doi.org/10.1182/blood.V98.13.3595 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11739162/ PubMed] [https://clinicaltrials.gov/study/NCT00048737 NCT00048737]
##'''Update:''' Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. [http://www.bloodjournal.org/content/111/12/5530.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624452/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18411419 PubMed]
+
##'''Update:''' Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. [https://doi.org/10.1182/blood-2008-01-136242 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4624452/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/18411419/ PubMed]
##'''Update:''' Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. [http://www.bloodjournal.org/content/119/26/6373.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347306/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/22586182 PubMed]
+
##'''Update:''' Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. [https://doi.org/10.1182/blood-2012-03-417808 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347306/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/22586182/ PubMed]
=Hepatic veno-occlusive disease (VOD), all lines of therapy=
+
 
''Also known as sinusoidal obstructive syndrome (SOS)''
 
==Defibrotide monotherapy {{#subobject:pyr1|Regimen=1}}==
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #1, treatment {{#subobject:pyv1|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Years of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817309/ Richardson et al. 2016 (DFCI 2005-01)]
 
|2006-2008
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
|"32 historical controls"
 
| style="background-color:#91cf60" |Seems to have superior survival at day +100
 
|-
 
|}
 
''Note: If after 21 days signs and symptoms of VOD have not resolved, give until VOD is resolved, up to a maximum of 60 days.''
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Supportive therapy====
 
*[[Defibrotide (Defitelio)]] 6.25 mg/kg IV over 2 hours every 6 hours
 
'''21- to 60-day course'''
 
</div></div><br>
 
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #2, prophylaxis {{#subobject:0e9fee|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
!style="width: 20%"|Study
 
!style="width: 20%"|Years of enrollment
 
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 20%"|Comparator
 
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
|-
 
|[https://doi.org/10.1016/s0140-6736(11)61938-7 Corbacioglu et al. 2012 (VOD-DF)]
 
|2006-2009
 
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
|[[#Observation_88|Observation]]
 
| style="background-color:#91cf60" |Seems to have lower incidence of VOD
 
|-
 
|}
 
<div class="toccolours" style="background-color:#b3e2cd">
 
====Supportive therapy====
 
*[[Defibrotide (Defitelio)]] 6.25 mg/kg IV over 2 hours every 6 hours
 
'''Begins on first day of preparative regimen, continues for at least 14 days or until day +30'''
 
</div></div>
 
===References===
 
#'''VOD-DF:''' Corbacioglu S, Cesaro S, Faraci M, Valteau-Couanet D, Gruhn B, Rovelli A, Boelens JJ, Hewitt A, Schrum J, Schulz AS, Müller I, Stein J, Wynn R, Greil J, Sykora KW, Matthes-Martin S, Führer M, O'Meara A, Toporski J, Sedlacek P, Schlegel PG, Ehlert K, Fasth A, Winiarski J, Arvidson J, Mauz-Körholz C, Ozsahin H, Schrauder A, Bader P, Massaro J, D'Agostino R, Hoyle M, Iacobelli M, Debatin KM, Peters C, Dini G. Defibrotide for prophylaxis of hepatic veno-occlusive disease in paediatric haemopoietic stem-cell transplantation: an open-label, phase 3, randomised controlled trial. Lancet. 2012 Apr 7;379(9823):1301-9. Epub 2012 Feb 23. [https://doi.org/10.1016/s0140-6736(11)61938-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22364685 PubMed] NCT00272948
 
#'''DFCI 2005-01:''' Richardson PG, Riches ML, Kernan NA, Brochstein JA, Mineishi S, Termuhlen AM, Arai S, Grupp SA, Guinan EC, Martin PL, Steinbach G, Krishnan A, Nemecek ER, Giralt S, Rodriguez T, Duerst R, Doyle J, Antin JH, Smith A, Lehmann L, Champlin R, Gillio A, Bajwa R, D'Agostino RB Sr, Massaro J, Warren D, Miloslavsky M, Hume RL, Iacobelli M, Nejadnik B, Hannah AL, Soiffer RJ. Phase 3 trial of defibrotide for the treatment of severe veno-occlusive disease and multi-organ failure. Blood. 2016 Jan 29. [https://doi.org/10.1182/blood-2015-10-676924 link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817309/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/26825712 PubMed] NCT00358501
 
 
[[Category:Allogeneic HSCT regimens]]
 
[[Category:Allogeneic HSCT regimens]]
 
[[Category:Site-agnostic regimens]]
 
[[Category:Site-agnostic regimens]]

Latest revision as of 23:52, 25 June 2024

Section editor
Talal Hilal, MD
Mayo Clinic
Phoenix, AZ, USA

Unlike the other chemotherapy regimen pages, this one is not disease-specific. Rather, this is a gathering point for all allogeneic hematopoietic stem cell transplant (HSCT) conditioning regimens. Unless otherwise specified, the day before HSCT is day -1, the day of HSCT is day 0, and the day after HSCT is day +1. As with the rest of the HemOnc.org website, the focus here is on regimens used in the treatment of hematologic or oncologic conditions; there are roles for allogeneic HSCT outside of hematology/oncology but these use cases are considered to be out of scope.


These links will take you to highly related pages:

23 regimens on this page
41 variants on this page


Myeloablative regimens, all lines of therapy

BuCyTBI

BuCyTBI: Busulfan, Cyclophosphamide, Total Body Irradiation

Regimen

Study Evidence
Fefer et al. 1979 Pilot, fewer than 20 pts

Chemotherapy

Radiotherapy

  • TBI 920 rads on day 0

Immunotherapy

One course

References

  1. Fefer A, Cheever MA, Thomas ED, Boyd C, Ramberg R, Glucksberg H, Buckner CD, Storb R. Disappearance of Ph1-positive cells in four patients with chronic granulocytic leukemia after chemotherapy, irradiation and marrow transplantation from an identical twin. N Engl J Med. 1979 Feb 15;300(7):333-7. link to original article contains dosing details in manuscript PubMed

Busulfan & Cyclophosphamide

BuCy: Busulfan & Cyclophosphamide

Regimen variant #1, 3.2 x 4/120

Study Dates of enrollment Evidence Comparator Comparative Efficacy Non-relapse mortality
Kröger et al. 2017 (RICMAC) 2004-2012 Phase 3 (C) Bu/Flu RIC allo HSCT Might have inferior OS
Lee et al. 2013 (COSAH C-005) 2005-2009 Phase 3 (C) Busulfan & Fludarabine Seems to have superior OS (secondary endpoint)
Rambaldi et al. 2015 (GITMO-AMLR2) 2008-2012 Phase 3 (C) Busulfan & Fludarabine Seems to have inferior 1-year non-relapse mortality
Zhang et al. 2023 2016-01 to 2020-02 Phase 3 (E-switch-ooc) TBI-Cy Non-inferior OS24 (primary endpoint)
OS24: 76.6% vs 79.4%
Similar NRM
Xuan et al. 2023 2016-04-18 to 2019-09-30 Phase 3 (C) Busulfan, Cyclophosphamide, Decitabine, G-CSF Inferior CIR24

Chemotherapy

Immunotherapy

GVHD prophylaxis

Supportive therapy

  • Filgrastim (Neupogen) 450 mcg SC once per day, starting on day +5 and continued until ANC greater than 3000/μL

One course


Regimen variant #2, 0.8 x 16/120

Study Dates of enrollment Evidence Comparator Comparative Efficacy Non-relapse mortality
Andersson et al. 2002 1996-06 to 1997-12 Phase 2
Ling et al. 2023 2015-11-20 to 2019-09-30 Phase 3 (C) BuFlu Seems to have inferior TRM12

Chemotherapy

Immunotherapy

One course


Regimen variant #3, 1 x 16/200

Study Evidence
Santos et al. 1983 Non-randomized

Note: the day of allogeneic stem cell transplant is not specified in the protocol.

Chemotherapy

Immunotherapy

One course

References

  1. Santos GW, Tutschka PJ, Brookmeyer R, Saral R, Beschorner WE, Bias WB, Braine HG, Burns WH, Elfenbein GJ, Kaizer H, Mellits D, Sensenbrenner LL, Stuart RK, Yeager AM. Marrow transplantation for acute nonlymphocytic leukemia after treatment with busulfan and cyclophosphamide. N Engl J Med. 1983 Dec 1;309(22):1347-53. link to original article contains dosing details in abstract PubMed
  2. Andersson BS, Kashyap A, Gian V, Wingard JR, Fernandez H, Cagnoni PJ, Jones RB, Tarantolo S, Hu WW, Blume KG, Forman SJ, Champlin RE. Conditioning therapy with intravenous busulfan and cyclophosphamide (IV BuCy2) for hematologic malignancies prior to allogeneic stem cell transplantation: a phase II study. Biol Blood Marrow Transplant. 2002;8(3):145-54. link to original article contains dosing details in manuscript PubMed
  3. COSAH C-005: Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. Epub 2012 Nov 5. link to original article contains dosing details in manuscript PubMed NCT00774280
  4. GITMO-AMLR2: Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. link to original article PubMed NCT01191957
  5. RICMAC: Kröger N, Iacobelli S, Franke GN, Platzbecker U, Uddin R, Hübel K, Scheid C, Weber T, Robin M, Stelljes M, Afanasyev B, Heim D, Deliliers GL, Onida F, Dreger P, Pini M, Guidi S, Volin L, Günther A, Bethge W, Poiré X, Kobbe G, van Os M, Brand R, de Witte T. Dose-Reduced Versus Standard Conditioning Followed by Allogeneic Stem-Cell Transplantation for Patients With Myelodysplastic Syndrome: A Prospective Randomized Phase III Study of the EBMT (RICMAC Trial). J Clin Oncol. 2017 Jul 1;35(19):2157-2164. Epub 2017 May 2. link to original article PubMed NCT01203228
  6. Zhang H, Fan Z, Huang F, Han L, Xu Y, Xu N, Deng L, Wang S, Lin D, Luo X, Zhang Q, Liu X, Li X, Liang X, Xie S, Qu H, Yu S, Zhou H, Shi P, Xuan L, Lin R, Liu H, Jin H, Sun J, Liu Q. Busulfan Plus Cyclophosphamide Versus Total Body Irradiation Plus Cyclophosphamide for Adults Acute B Lymphoblastic Leukemia: An Open-Label, Multicenter, Phase III Trial. J Clin Oncol. 2023 Jan 10;41(2):343-353. Epub 2022 Sep 9. link to original article link to PMC article contains dosing details in manuscript PubMed NCT02670252
  7. Xuan L, Dai M, Jiang E, Wang Y, Huang F, Fan Z, Xu N, Nie D, Liang X, Chen H, Ye J, Shi P, Liu H, Jin H, Lin R, Yan C, Zhang Y, Sun J, Han M, Liu Q. The effect of granulocyte-colony stimulating factor, decitabine, and busulfan-cyclophosphamide versus busulfan-cyclophosphamide conditioning on relapse in patients with myelodysplastic syndrome or secondary acute myeloid leukaemia evolving from myelodysplastic syndrome undergoing allogeneic haematopoietic stem-cell transplantation: an open-label, multicentre, randomised, phase 3 trial. Lancet Haematol. 2023 Mar;10(3):e178-e190. Epub 2023 Jan 23. link to original article contains dosing details in abstract PubMed NCT02744742
  8. Ling Y, Xuan L, Xu N, Huang F, Fan Z, Guo Z, Xu X, Liu H, Lin R, Yu S, Zhang H, Jin H, Wu M, Liu C, Liang X, Ou R, Zhang Y, Liu X, Qu H, Zhai X, Sun J, Zhao Y, Liu Q. Busulfan Plus Fludarabine Compared With Busulfan Plus Cyclophosphamide for AML Undergoing HLA-Haploidentical Hematopoietic Cell Transplantation: A Multicenter Randomized Phase III Trial. J Clin Oncol. 2023 Oct 10;41(29):4632-4642. Epub 2023 Jun 19. link to original article contains dosing details in manuscript PubMed NCT02487069

Busulfan, Cyclophosphamide, Decitabine, G-CSF

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Xuan et al. 2023 2016-04-18 to 2019-09-30 Phase 3 (E-esc) BuCy Superior CIR24 (primary endpoint)
CIR24: 10.9% vs 24.8%
(HR 0.39, 95% CI 0.19-0.79)

Chemotherapy

Growth factor therapy

  • G-CSF 5 mcg/kg once per day on days -17 to -10

Immunotherapy

One course

References

  1. Xuan L, Dai M, Jiang E, Wang Y, Huang F, Fan Z, Xu N, Nie D, Liang X, Chen H, Ye J, Shi P, Liu H, Jin H, Lin R, Yan C, Zhang Y, Sun J, Han M, Liu Q. The effect of granulocyte-colony stimulating factor, decitabine, and busulfan-cyclophosphamide versus busulfan-cyclophosphamide conditioning on relapse in patients with myelodysplastic syndrome or secondary acute myeloid leukaemia evolving from myelodysplastic syndrome undergoing allogeneic haematopoietic stem-cell transplantation: an open-label, multicentre, randomised, phase 3 trial. Lancet Haematol. 2023 Mar;10(3):e178-e190. Epub 2023 Jan 23. link to original article contains dosing details in abstract PubMed NCT02744742

Busulfan & Fludarabine

BuFlu: Busulfan & Fludarabine
Flu/Bu: Fludarabine & Busulfan

Regimen variant #1

Study Dates of enrollment Evidence Comparator Comparative Efficacy Comparative Toxicity
Ling et al. 2023 2015-11-20 to 2019-09-30 Phase 3 (E-de-esc) Busulfan & Cyclophosphamide Seems to have superior TRMM12 (primary endpoint)

Diseases Studied: Acute myeloid leukemia

Chemotherapy

Immunotherapy

One course


Regimen variant #2

Study Dates of enrollment Evidence Comparator Comparative Efficacy Comparative Toxicity
Rambaldi et al. 2015 (GITMO-AMLR2) 2008-2012 Phase 3 (E-switch-ic) Busulfan & Cyclophosphamide Seems to have superior NRM12 (primary endpoint)

Diseases Studied: Acute myeloid leukemia
Graft types studied: Bone Marrow, Mobilized Peripheral Blood Stem Cells

Chemotherapy

GVHD prophylaxis, pre-transplant

  • Antithymocyte globulin, rabbit ATG (Thymoglobulin) by the following donor-based criteria:
    • Matched unrelated donors: 0.5 mg/kg IV once on day -3, then 2 mg/kg IV once on day -2, then 2.5 mg/kg IV once on day -1
    • Mismatched donors: total ATG dose could be increased to 7.5 mg/kg

Immunotherapy

GVHD prophylaxis, post-transplant

One course


Regimen variant #3

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Andersson et al. 2008 1997-2005 Non-randomized Suggested improved outcomes, but shorter follow up
Kanakry et al. 2014 (J0844) 2009-2011 Phase 2
Mielcarek et al. 2016 (FHCC 2541.00) 2011-2013 Phase 2 -

Diseases Studied: Acute myeloid leukemia, Myelodysplastic syndrome, Acute lymphocytic leukemia, Chronic myeloid leukemia, Non-Hodgkin lymphoma
Graft types studied: Matched Related / Unrelated Donor Bone Marrow, Mobilized Peripheral Blood Stem Cells

Chemotherapy

  • Busulfan (Myleran) 130 mg/m2 IV over 3 hours once per day on days -6 to -3
    • Dosing targeted for optimal pharmacokinetics but different parameters each institution, please consult the original publication for optimal levels
  • Fludarabine (Fludara) 40 mg/m2 IV over 60 minutes once per day on days -6 to -3, given first

GVHD prophylaxis, pre-transplant

Immunotherapy

GVHD prophylaxis, post-transplant

#1 Tacrolimus & methotrexate based (Andersson et al.)

Supportive therapy

  • All patients received Filgrastim (Neupogen) SC once per day from day +7 until achieving an absolute neutrophil count (ANC) ≥1.5 x 109/L for three days
  • Phenytoin (Dilantin) prophylaxis used during and for one day after IV busulfan

#2 Post-Transplant Cy based (Kanakry et al. and FHCC 2541.00)

GVHD prophylaxis

  • Cyclophosphamide (Cytoxan) 50 mg/kg IV once per day on days +3 & +4 (used alone in Kanakry et al. when all patients received bone marrow grafts)
  • ± Cyclosporine intravenous loading dose of CSP was given on day 5, followed by subsequent twice per day dosing adjusted to maintain whole blood trough at 120 to 360 ng/mL. In abscence of GVHD Cyclosporine was tapered from day +56 through day +126 (used in FHCC 2541.00 with PBSCT grafts)

Supportive therapy

One course


Regimen variant #4

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Lee et al. 2013 (COSAH C-005) 2005-2009 Phase 3 (E-switch-ic) Busulfan & Cyclophosphamide Seems to have inferior OS (secondary endpoint)

Diseases Studied: Acute myeloid leukemia, Myelodysplastic syndrome, Acute lymphocytic leukemia, Chronic myeloid leukemia, Myelofibrosis
Graft types studied: Matched Related / Unrelated Donor Bone Marrow, Mobilized Peripheral Blood Stem Cells

Chemotherapy

  • Busulfan (Myleran) 3.2 mg/kg IV once per day on days -7 to -4, given first on days overlapping with fludarabine (total dose: 12.8 mg/kg)
  • Fludarabine (Fludara) 30 mg/m2 IV once per day on days -6 to -2, given second on days overlapping with busulfan

Immunotherapy

GVHD prophylaxis

Supportive therapy

  • Filgrastim (Neupogen) 450 mcg SC once per day, starting on day +5 and continued until ANC greater than 3000/μL

One course


Regimen variant #5

Study Dates of enrollment Evidence
Russell et al. 2002 1999-2001 Phase 2

Diseases Studied: Acute myeloid leukemia, Myelodysplastic syndrome, Chronic myeloid leukemia, Chronic lymphocytic leukemia, Non-Hodgkin lymphoma, Hypereosinophilic syndrome
Graft types studied: Matched Related / Unrelated Donor Bone Marrow or Mobilized Peripheral Blood Stem Cells

Chemotherapy

Immunotherapy

GVHD prophylaxis

Supportive therapy

  • Leucovorin (Folinic acid) 5 mg started 24 hours after each dose of methotrexate and continued every 6 hours until 12 hours before the next dose of methotrexate
  • Phenytoin (Dilantin) "loading" PO/IV, dosed to maintain therapeutic levels of 40 to 80 umol/L on days -5 to -2

One course

References

  1. Russell JA, Tran HT, Quinlan D, Chaudhry A, Duggan P, Brown C, Stewart D, Ruether JD, Morris D, Glick S, Gyonyor E, Andersson BS. Once-daily intravenous busulfan given with fludarabine as conditioning for allogeneic stem cell transplantation: study of pharmacokinetics and early clinical outcomes. Biol Blood Marrow Transplant. 2002;8(9):468-76. link to original article contains dosing details in manuscript PubMed
  2. de Lima M, Couriel D, Thall PF, Wang X, Madden T, Jones R, Shpall EJ, Shahjahan M, Pierre B, Giralt S, Korbling M, Russell JA, Champlin RE, Andersson BS. Once-daily intravenous busulfan and fludarabine: clinical and pharmacokinetic results of a myeloablative, reduced-toxicity conditioning regimen for allogeneic stem cell transplantation in AML and MDS. Blood. 2004 Aug 1;104(3):857-64. Epub 2004 Apr 8. link to original article PubMed
  3. Andersson BS, de Lima M, Thall PF, Wang X, Couriel D, Korbling M, Roberson S, Giralt S, Pierre B, Russell JA, Shpall EJ, Jones RB, Champlin RE. Once daily IV busulfan and fludarabine (IV Bu-Flu) compares favorably with IV busulfan and cyclophosphamide (IV BuCy2) as pretransplant conditioning therapy in AML/MDS. Biol Blood Marrow Transplant. 2008;14(6):672-84. link to original article link to PMC article contains dosing details in manuscript PubMed
  4. COSAH C-005: Lee JH, Joo YD, Kim H, Ryoo HM, Kim MK, Lee GW, Lee JH, Lee WS, Park JH, Bae SH, Hyun MS, Kim DY, Kim SD, Min YJ, Lee KH. Randomized trial of myeloablative conditioning regimens: busulfan plus cyclophosphamide versus busulfan plus fludarabine. J Clin Oncol. 2013 Feb 20;31(6):701-9. Epub 2012 Nov 5. link to original article contains dosing details in manuscript PubMed NCT00774280
  5. J0844: Kanakry CG, O'Donnell PV, Furlong T, de Lima MJ, Wei W, Medeot M, Mielcarek M, Champlin RE, Jones RJ, Thall PF, Andersson BS, Luznik L. Multi-institutional study of post-transplantation cyclophosphamide as single-agent graft-versus-host disease prophylaxis after allogeneic bone marrow transplantation using myeloablative busulfan and fludarabine conditioning. J Clin Oncol. 2014; 32(31):3497-505. Epub 2014 Sep 29. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00809276
  6. FHCC 2541.00: Mielcarek M, Furlong T, O'Donnell PV, Storer BE, McCune JS, Storb R, Carpenter PA, Flowers ME, Appelbaum FR, Martin PJ. Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation. Blood. 2016;127(11):1502-8. Epub 2016 Jan 13. link to original article contains dosing details in manuscript link to PMC article PubMed NCT01427881
  7. GITMO-AMLR2: Rambaldi A, Grassi A, Masciulli A, Boschini C, Micò MC, Busca A, Bruno B, Cavattoni I, Santarone S, Raimondi R, Montanari M, Milone G, Chiusolo P, Pastore D, Guidi S, Patriarca F, Risitano AM, Saporiti G, Pini M, Terruzzi E, Arcese W, Marotta G, Carella AM, Nagler A, Russo D, Corradini P, Alessandrino EP, Torelli GF, Scimè R, Mordini N, Oldani E, Marfisi RM, Bacigalupo A, Bosi A. Busulfan plus cyclophosphamide versus busulfan plus fludarabine as a preparative regimen for allogeneic haemopoietic stem-cell transplantation in patients with acute myeloid leukaemia: an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol. 2015 Nov;16(15):1525-36. Epub 2015 Sep 28. link to original article PubMed NCT01191957
  8. MDACC 2011-0628: Andersson BS, Thall PF, Ma J, Valdez BC, Bassett R Jr, Chen J, Ahmed S, Alousi A, Bashir Q, Ciurea S, Gulbis A, Cool R, Kawedia J, Hosing C, Kebriaei P, Kornblau S, Myers A, Oran B, Rezvani K, Shah N, Shpall E, Parmar S, Popat UR, Nieto Y, Champlin RE. A randomized phase III study of pretransplant conditioning for AML/MDS with fludarabine and once daily IV busulfan ± clofarabine in allogeneic stem cell transplantation. Bone Marrow Transplant. 2022 Aug;57(8):1295-1303. Epub 2022 May 24. link to original article link to PMC article PubMed NCT01471444
  9. Ling Y, Xuan L, Xu N, Huang F, Fan Z, Guo Z, Xu X, Liu H, Lin R, Yu S, Zhang H, Jin H, Wu M, Liu C, Liang X, Ou R, Zhang Y, Liu X, Qu H, Zhai X, Sun J, Zhao Y, Liu Q. Busulfan Plus Fludarabine Compared With Busulfan Plus Cyclophosphamide for AML Undergoing HLA-Haploidentical Hematopoietic Cell Transplantation: A Multicenter Randomized Phase III Trial. J Clin Oncol. 2023 Oct 10;41(29):4632-4642. Epub 2023 Jun 19. link to original article contains dosing details in manuscript PubMed NCT02487069

Cyclophosphamide & TBI

Cy/TBI: Cyclophosphamide & Total Body Irradiation
TBI-CY: Total Body Irradiation & Cyclophosphamide

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy Non-relapse mortality
Rudolph et al. 1973 1968-1970 Non-randomized
Fefer et al. 1982 1971-1980 Non-randomized, fewer than 20 pts
Thomas et al. 1979 1976-1977 Non-randomized
Blume et al. 1980 1976-1979 Non-randomized, fewer than 20 pts
Johnson et al. 1981 1976-1980 Non-randomized
Brochstein et al. 1987 1979-1985 Non-randomized
Goldman et al. 1986 1981-1984 Non-randomized
Kersey et al. 1987 1982-1985 Quasi-randomized Auto HSCT Superior RFS
Hansen et al. 1998 1985-1994 Non-randomized
Sebban et al. 1994 (LALA 87) 1986-1991 Phase 3 (E-esc) Chemotherapy or Auto HSCT Did not meet co-primary endpoints of DFS/OS
Zittoun et al. 1995 1986-1993 Phase 3 (E-esc) Intensive chemotherapy Superior DFS
Thomas et al. 2004 (LALA-94) 1994-2002 Non-randomized part of RCT
Bornhäuser et al. 2012 (9005-2003) 2004-2009 Phase 3 (C) Fludarabine & TBI Did not meet primary endpoint of NRM
Zhang et al. 2023 2016-01 to 2020-02 Phase 3 (C) BuCy Non-inferior OS24 Similar NRM

Details in most of the manuscripts are limited.

Chemotherapy

Radiotherapy

  • Total body irradiation by the following study-specific criteria:
    • Zhang et al. 2023: 450 cGy once per day on days -5 & -4 (900 cGy total)
    • Other studies: 10 to 1200 cGy total

Immunotherapy

One course

References

  1. Rudolph RH, Fefer A, Thomas ED, Buckner CD, Clift RA, Storb R. Isogeneic marrow grafts for hematologic malignancy in man. Arch Intern Med. 1973 Aug;132(2):279-85. link to original article PubMed
    1. Update: Fefer A, Einstein AB, Thomas ED, Buckner CD, Clift RA, Glucksberg H, Neiman PE, Storb R. Bone-marrow transplantation for hematologic neoplasia in 16 patients with identical twins. N Engl J Med. 1974 Jun 20;290(25):1389-93. link to original article PubMed
  2. Thomas ED, Sanders JE, Flournoy N, Johnson FL, Buckner CD, Clift RA, Fefer A, Goodell BW, Storb R, Weiden PL. Marrow transplantation for patients with acute lymphoblastic leukemia in remission. Blood. 1979 Aug;54(2):468-76. link to original article contains dosing details in abstract PubMed
  3. Blume KG, Beutler E, Bross KJ, Chillar RK, Ellington OB, Fahey JL, Farbstein MJ, Forman SJ, Schmidt GM, Scott EP, Spruce WE, Turner MA, Wolf JL. Bone-marrow ablation and allogeneic marrow transplantation in acute leukemia. N Engl J Med. 1980 May 8;302(19):1041-6. link to original article PubMed
  4. Johnson FL, Thomas ED, Clark BS, Chard RL, Hartmann JR, Storb R. A comparison of marrow transplantation with chemotherapy for children with acute lymphoblastic leukemia in second or subsequent remission. N Engl J Med. 1981 Oct 8;305(15):846-51. link to original article PubMed
  5. Fefer A, Cheever MA, Greenberg PD, Appelbaum FR, Boyd CN, Buckner CD, Kaplan HG, Ramberg R, Sanders JE, Storb R, Thomas ED. Treatment of chronic granulocytic leukemia with chemoradiotherapy and transplantation of marrow from identical twins. N Engl J Med. 1982 Jan 14;306(2):63-8. link to original article PubMed
  6. Goldman JM, Apperley JF, Jones L, Marcus R, Goolden AW, Batchelor R, Hale G, Waldmann H, Reid CD, Hows J, Gordon-Smith E, Catovsky D, Galton DAG. Bone marrow transplantation for patients with chronic myeloid leukemia. N Engl J Med. 1986 Jan 23;314(4):202-7. PubMed
  7. Kersey JH, Weisdorf D, Nesbit ME, LeBien TW, Woods WG, McGlave PB, Kim T, Vallera DA, Goldman AI, Bostrom B, Hurd D, Ramsay NKC. Comparison of autologous and allogeneic bone marrow transplantation for treatment of high-risk refractory acute lymphoblastic leukemia. N Engl J Med. 1987 Aug 20;317(8):461-7. link to original article PubMed
  8. Brochstein JA, Kernan NA, Groshen S, Cirrincione C, Shank B, Emanuel D, Laver J, O'Reilly RJ. Allogeneic bone marrow transplantation after hyperfractionated total-body irradiation and cyclophosphamide in children with acute leukemia. N Engl J Med. 1987 Dec 24;317(26):1618-24. link to original article PubMed
  9. LALA 87: Sebban C, Lepage E, Vernant JP, Gluckman E, Attal M, Reiffers J, Sutton L, Racadot E, Michallet M, Maraninchi D, Dreyfus F, Fiere D; French Group of Therapy of Adult Acute Lymphoblastic Leukemia. Allogeneic bone marrow transplantation in adult acute lymphoblastic leukemia in first complete remission: a comparative study. J Clin Oncol. 1994 Dec;12(12):2580-7. link to original article PubMed
    1. Update: Thiebaut A, Vernant JP, Degos L, Huguet FR, Reiffers J, Sebban C, Lepage E, Thomas X, Fière D. Adult acute lymphocytic leukemia study testing chemotherapy and autologous and allogeneic transplantation: a follow-up report of the French protocol LALA 87. Hematol Oncol Clin North Am. 2000 Dec;14(6):1353-66. link to original article PubMed
  10. Zittoun RA, Mandelli F, Willemze R, de Witte T, Labar B, Resegotti L, Leoni F, Damasio E, Visani G, Papa G, Caronia F, Hayat M, Stryckmans P, Rotoli B, Leoni P, Peetermans ME, Dardenne M, Vegna ML, Petti MC, Solbu G, Suciu S; EORTC; Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. N Engl J Med. 1995 Jan 26;332(4):217-23. link to original article contains dosing details in abstract PubMed
  11. Hansen JA, Gooley TA, Martin PJ, Appelbaum F, Chauncey TR, Clift RA, Petersdorf EW, Radich J, Sanders JE, Storb RF, Sullivan KM, Anasetti C. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med. 1998 Apr 2;338(14):962-8. link to original article PubMed
  12. LALA-94: Thomas X, Boiron JM, Huguet F, Dombret H, Bradstock K, Vey N, Kovacsovics T, Delannoy A, Fegueux N, Fenaux P, Stamatoullas A, Vernant JP, Tournilhac O, Buzyn A, Reman O, Charrin C, Boucheix C, Gabert J, Lhéritier V, Fiere D. Outcome of treatment in adults with acute lymphoblastic leukemia: analysis of the LALA-94 trial. J Clin Oncol. 2004 Oct 15;22(20):4075-86. Epub 2004 Sep 7. link to original article contains dosing details in manuscript PubMed NCT00002700
    1. Update: Vey N, Thomas X, Picard C, Kovascovicz T, Charin C, Cayuela JM, Dombret H, Dastugue N, Huguet F, Bastard C, Stamatoulas A, Giollant M, Tournilhac O, Macintyre E, Buzyn A, Bories D, Kuentz M, Dreyfus F, Delannoy A, Raynaud S, Gratecos N, Bordessoule D, de Botton S, Preudhomme C, Reman O, Troussard X, Pigneux A, Bilhou C, Vernant JP, Boucheix C, Gabert J; Swiss Group for Clinical Cancer Research. Allogeneic stem cell transplantation improves the outcome of adults with t(1;19)/E2A-PBX1 and t(4;11)/MLL-AF4 positive B-cell acute lymphoblastic leukemia: results of the prospective multicenter LALA-94 study. Leukemia. 2006 Dec;20(12):2155-61. Epub 2006 Oct 12. link to original article PubMed
  13. 9005-2003: Bornhäuser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, Baurmann H, Schäfer-Eckart K, Holler E, Kröger N, Schmid C, Einsele H, Kiehl MG, Hiddemann W, Schwerdtfeger R, Buchholz S, Dreger P, Neubauer A, Berdel WE, Ehninger G, Beelen DW, Schetelig J, Stelljes M. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012 Oct;13(10):1035-44. Epub 2012 Sep 7. link to original article contains dosing details in abstract PubMed NCT00150878
  14. Retrospective: Copelan EA, Hamilton BK, Avalos B, Ahn KW, Bolwell BJ, Zhu X, Aljurf M, van Besien K, Bredeson C, Cahn JY, Costa LJ, de Lima M, Gale RP, Hale GA, Halter J, Hamadani M, Inamoto Y, Kamble RT, Litzow MR, Loren AW, Marks DI, Olavarria E, Roy V, Sabloff M, Savani BN, Seftel M, Schouten HC, Ustun C, Waller EK, Weisdorf DJ, Wirk B, Horowitz MM, Arora M, Szer J, Cortes J, Kalaycio ME, Maziarz RT, Saber W. Better leukemia-free and overall survival in AML in first remission following cyclophosphamide in combination with busulfan compared with TBI. Blood. 2013 Dec 5;122(24):3863-70. Epub 2013 Sep 24. link to original article link to PMC article PubMed
  15. Zhang H, Fan Z, Huang F, Han L, Xu Y, Xu N, Deng L, Wang S, Lin D, Luo X, Zhang Q, Liu X, Li X, Liang X, Xie S, Qu H, Yu S, Zhou H, Shi P, Xuan L, Lin R, Liu H, Jin H, Sun J, Liu Q. Busulfan Plus Cyclophosphamide Versus Total Body Irradiation Plus Cyclophosphamide for Adults Acute B Lymphoblastic Leukemia: An Open-Label, Multicenter, Phase III Trial. J Clin Oncol. 2023 Jan 10;41(2):343-353. Epub 2022 Sep 9. link to original article link to PMC article contains dosing details in manuscript PubMed NCT02670252
  16. SWOG S9920: NCT00005866

Etoposide & TBI

Regimen variant #1, weight-based etoposide

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Balduzzi et al. 2005 1995-2000 Quasi-randomized Chemotherapy Seems to have superior DFS
Peters et al. 2015 (ALL-SCT-BFM 2003) 2003-2011 Non-randomized

This regimen was evaluated in the treatment of high-risk pediatric acute lymphoblastic leukemia in CR1.

Chemotherapy

Radiotherapy

Immunotherapy

One course


Regimen variant #2, BSA-based etoposide

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Peters et al. 2020 (FORUM) 2013-2018 Phase 3 (C) 1a. Busulfan, Fludarabine, Thiotepa
1b. Fludarabine, Thiotepa, Treosulfan
Superior OS (primary endpoint)

This regimen was evaluated in the treatment of high-risk pediatric acute lymphoblastic leukemia in CMR.

Chemotherapy

Radiotherapy

Immunotherapy

One course


Regimen variant #3, 1320 cGy

Study Dates of enrollment Evidence
Rowe et al. 2005 (MRC UKALL XII/ECOG E2993) 1993-2003 Non-randomized part of phase 3 RCT

Note: this is the same preparative regimen used for autologous transplant for certain patients; see reference for details. This regimen was evaluated in the treatment of acute lymphoblastic leukemia in CR1.

Chemotherapy

Radiotherapy

Immunotherapy

One course

References

  1. Balduzzi A, Valsecchi MG, Uderzo C, De Lorenzo P, Klingebiel T, Peters C, Stary J, Felice MS, Magyarosy E, Conter V, Reiter A, Messina C, Gadner H, Schrappe M. Chemotherapy versus allogeneic transplantation for very-high-risk childhood acute lymphoblastic leukaemia in first complete remission: comparison by genetic randomisation in an international prospective study. Lancet. 2005 Aug 20-26;366(9486):635-42. link to original article contains dosing details in manuscript PubMed
  2. MRC UKALL XII/ECOG E2993: Rowe JM, Buck G, Burnett AK, Chopra R, Wiernik PH, Richards SM, Lazarus HM, Franklin IM, Litzow MR, Ciobanu N, Prentice HG, Durrant J, Tallman MS, Goldstone AH; ECOG; MRC/NCRI Adult Leukemia Working Party. Induction therapy for adults with acute lymphoblastic leukemia: results of more than 1500 patients from the international ALL trial: MRC UKALL XII/ECOG E2993. Blood. 2005 Dec 1;106(12):3760-7. Epub 2005 Aug 16. link to original article contains dosing details in manuscript PubMed NCT00002514
    1. Update: Goldstone AH, Richards SM, Lazarus HM, Tallman MS, Buck G, Fielding AK, Burnett AK, Chopra R, Wiernik PH, Foroni L, Paietta E, Litzow MR, Marks DI, Durrant J, McMillan A, Franklin IM, Luger S, Ciobanu N, Rowe JM. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allogeneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). Blood. 2008 Feb 15;111(4):1827-33. Epub 2007 Nov 29. link to original article PubMed
    2. Update: Fielding AK, Rowe JM, Richards SM, Buck G, Moorman AV, Durrant IJ, Marks DI, McMillan AK, Litzow MR, Lazarus HM, Foroni L, Dewald G, Franklin IM, Luger SM, Paietta E, Wiernik PH, Tallman MS, Goldstone AH. Prospective outcome data on 267 unselected adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia confirms superiority of allogeneic transplantation over chemotherapy in the pre-imatinib era: results from the International ALL Trial MRC UKALLXII/ECOG2993. Blood. 2009 May 7;113(19):4489-96. Epub 2009 Feb 24. link to original article link to PMC article PubMed
    3. Update: Fielding AK, Rowe JM, Buck G, Foroni L, Gerrard G, Litzow MR, Lazarus H, Luger SM, Marks DI, McMillan AK, Moorman AV, Patel B, Paietta E, Tallman MS, Goldstone AH. UKALLXII/ECOG2993: addition of imatinib to a standard treatment regimen enhances long-term outcomes in Philadelphia positive acute lymphoblastic leukemia. Blood. 2014 Feb 6;123(6):843-50. Epub 2013 Nov 25. link to original article contains dosing details in manuscript link to PMC article PubMed
  3. ALL-SCT-BFM-2003: Peters C, Schrappe M, von Stackelberg A, Schrauder A, Bader P, Ebell W, Lang P, Sykora KW, Schrum J, Kremens B, Ehlert K, Albert MH, Meisel R, Matthes-Martin S, Gungor T, Holter W, Strahm B, Gruhn B, Schulz A, Woessmann W, Poetschger U, Zimmermann M, Klingebiel T. Stem-cell transplantation in children with acute lymphoblastic leukemia: a prospective international multicenter trial comparing sibling donors with matched unrelated donors-the ALL-SCT-BFM-2003 trial. J Clin Oncol. 2015 Apr 10;33(11):1265-74. Epub 2015 Mar 9. link to original article PubMed NCT01423747
  4. FORUM: Peters C, Dalle JH, Locatelli F, Poetschger U, Sedlacek P, Buechner J, Shaw PJ, Staciuk R, Ifversen M, Pichler H, Vettenranta K, Svec P, Aleinikova O, Stein J, Güngör T, Toporski J, Truong TH, Diaz-de-Heredia C, Bierings M, Ariffin H, Essa M, Burkhardt B, Schultz K, Meisel R, Lankester A, Ansari M, Schrappe M, von Stackelberg A, Balduzzi A, Corbacioglu S, Bader P; IBFM Study Group; IntReALL Study Group; I-BFM SCT Study Group; EBMT Paediatric Diseases Working Party. Total Body Irradiation or Chemotherapy Conditioning in Childhood ALL: A Multinational, Randomized, Noninferiority Phase III Study. J Clin Oncol. 2021 Feb 1;39(4):295-307. Epub 2020 Dec 17. link to original article contains dosing details in manuscript link to PMC article PubMed NCT01949129

Fludarabine, Busulfan, Cyclophosphamide

FluBuCy: Fludarabine, Busulfan, Cyclophosphamide

Regimen variant #1, oral

Study Dates of enrollment Evidence
Glass et al. 2014 (DSHNHL R3) 2004-06-16 to 2009-03-24 Phase 2

This is described by the authors as a lymphoma-directed myeloablative conditioning regimen

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course


Regimen variant #2, intravenous

Study Dates of enrollment Evidence
Glass et al. 2014 (DSHNHL R3) 2004-06-16 to 2009-03-24 Phase 2

This is described by the authors as a lymphoma-directed myeloablative conditioning regimen

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. DSHNHL R3: Glass B, Hasenkamp J, Wulf G, Dreger P, Pfreundschuh M, Gramatzki M, Silling G, Wilhelm C, Zeis M, Görlitz A, Pfeiffer S, Hilgers R, Truemper L, Schmitz N; German High-Grade Lymphoma Study Group. Rituximab after lymphoma-directed conditioning and allogeneic stem-cell transplantation for relapsed and refractory aggressive non-Hodgkin lymphoma (DSHNHL R3): an open-label, randomised, phase 2 trial. Lancet Oncol. 2014 Jun;15(7):757-66. Epub 2014 May 11. link to original article link to original protocol (in German) contains dosing details in manuscript PubMed NCT00785330

Fludarabine & TBI for haploidentical transplant

Flu/TBI: Fludarabine and Total Body Irradiation

Regimen

Study Dates of enrollment Evidence
Soloman et al. 2014 2012-04 to 2014-05 Phase 2

Chemotherapy

Radiotherapy

Immunotherapy

GVHD prophylaxis

  • Cyclophosphamide (Cytoxan) 50 mg/kg IBW IV over 1 to 2 hours once per day on days +3 & +4, started 60 to 72 hours after marrow infusion
  • Mycophenolate mofetil (CellCept) 15 mg/kg (maximum daily dose of 3000 mg; route not specified) every 8 hours, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
  • Tacrolimus (Prograf) (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180

One course

References

  1. Solomon SR, Sizemore CA, Sanacore M, Zhang X, Brown S, Holland HK, Morris LE, Bashey A. Total Body Irradiation-Based Myeloablative Haploidentical Stem Cell Transplantation Is a Safe and Effective Alternative to Unrelated Donor Transplantation in Patients Without Matched Sibling Donors. Biol Blood Marrow Transplant. 2015 Jul;21(7):1299-307. Epub 2015 Mar 19. link to original article contains dosing details in manuscript PubMed

BEAM

BEAM: BCNU (Carmustine), Etoposide, Ara-C (Cytarabine), Melphalan

Regimen variant #1

Study Evidence
Przepiorka et al. 1999 Phase 2

Chemotherapy

Immunotherapy

GVHD prophylaxis

Supportive therapy

  • "Prophylactic antibiotics"
  • Filgrastim (Neupogen) 5 mcg/kg SC once per day, starting on day +7 and continued until engraftment

One course


Regimen variant #2, attenuated

Study Dates of enrollment Evidence
Sobol et al. 2013 2000-05 to 2012-04 Phase 2

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. Przepiorka D, van Besien K, Khouri I, Hagemeister F, Samuels B, Folloder J, Ueno NT, Molldrem J, Mehra R, Körbling M, Giralt S, Gajewski J, Donato M, Cleary K, Claxton D, Braunschweig I, Andersson B, Anderlini P, Champlin R. Carmustine, etoposide, cytarabine and melphalan as a preparative regimen for allogeneic transplantation for high-risk malignant lymphoma. Ann Oncol. 1999 May;10(5):527-32. link to original article contains dosing details in abstract PubMed
  2. Sobol U, Rodriguez T, Smith S, Go A, Vimr R, Parthasarathy M, Guo R, Stiff P. Seven-year follow-up of allogeneic transplant using BCNU, etoposide, cytarabine and melphalan chemotherapy in patients with Hodgkin lymphoma after autograft failure: importance of minimal residual disease. Leuk Lymphoma. 2014 Jun;55(6):1281-7. Epub 2013 Oct 3. link to original article contains dosing details in manuscript PubMed

BFR

BFR: Bendamustine, Fludarabine, Rituximab

Regimen

Study Dates of enrollment Evidence
Khouri et al. 2014 (MDACC 2008-0246) 2009-04 to 2013-02 Phase 2

Chemotherapy

Targeted therapy

Immunotherapy

GVHD prophylaxis

  • See article for GVHD prophylaxis information

One course

References

  1. MDACC 2008-0246: Khouri IF, Wei W, Korbling M, Turturro F, Ahmed S, Alousi A, Anderlini P, Ciurea S, Jabbour E, Oran B, Popat UR, Rondon G, Bassett RL Jr, Gulbis A. BFR (bendamustine, fludarabine, and rituximab) allogeneic conditioning for chronic lymphocytic leukemia/lymphoma: reduced myelosuppression and GVHD. Blood. 2014 Oct 2;124(14):2306-12. Epub 2014 Aug 21. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00880815

Reduced-intensity conditioning (RIC), all lines of therapy

Busulfan & Fludarabine

BuFlu: Busulfan & Fludarabine
Flu/Bu: Fludarabine & Busulfan

Regimen variant #1, 90/6.4

Study Dates of enrollment Evidence Comparator Comparative Efficacy
de Masson et al. 2023 (CUTALLO) 2016-06-01 to 2022-03-03 Propensity score analysis (E-esc) No transplant Superior PFS (primary endpoint)
Median PFS: 9 vs 3 mo
(HR 0.38, 95% CI 0.21-0.69)

Diseases Studied: Cutaneous T-cell lymphoma

Chemotherapy

Immunotherapy

GVHD prophylaxis

  • Cyclosporine started on day -1, tapered on day +90 if no GVHD
  • Methotrexate (MTX) 15 mg/m2 IV once on day +1, then 10 mg/m2 IV once per day on days +3, +6, +11

One course


Regimen variant #2, 125/4

Study Dates of enrollment Evidence
Garban et al. 2006 (IFM99-03) 2000-04 to 2004-09 Non-randomized

This regimen was meant for patients who had an HLA-identical sibling donor, and was evaluated in multiple myeloma patients.

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course

Dose and schedule modifications

  • Cyclosporine doses adjusted to "serum levels", tapered on day +60 to off by day +100 (if no GVHD)


Regimen variant #3, 150/6.4

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Devine et al. 2015 (CALGB 100103) 2004-2011 Phase 2
Beelen et al. 2019 (MC-FludT.14/L) 2013-2016 Phase 3 (C) Fludarabine & Treosulfan Non-inferior EFS24

This regimen is meant for related donors; in CALGB 100103, 8 patients received this regimen before the addition of ATG (rabbit) after 2006.

Chemotherapy

  • Fludarabine (Fludara) 30 mg/m2 IV over 30 minutes once per day on days -7 to -3
    • MC-FludT.14/L gave the doses on days -6 to -2
  • Busulfan (Myleran) 0.8 mg/kg IV over 2 hours every 6 hours on days -4 & -3 (total dose: 6.4 mg/kg)

Immunotherapy

GVHD prophylaxis

  • ATG (Rabbit) 2.5 mg/kg IV over 6 hours once per day on days -4 to -2
  • Tacrolimus (Prograf) with doses adjusted to maintain levels of 5 to 10 ng/mL, tapered on day +90 to off by day +180 (if no GVHD)
  • Methotrexate (MTX) 5 mg/m2 IV once per day on days +1, +3, +6, +11

One course


Regimen variant #4, 150/360

Study Dates of enrollment Evidence
Mohty et al. 2014 (ITT 08-01) 2009-2011 Phase 2

Chemotherapy

GVHD prophylaxis

Immunotherapy

One course


Regimen variant #5, 180/8

Study Evidence
Slavin et al. 1998 Phase 2
Schetelig et al. 2003 Phase 2

Chemotherapy

GVHD prophylaxis

  • ATG-Fresenius 10 mg/kg IV once per day on days -4 to -1 (4 consecutive days)

Immunotherapy

One course

References

  1. Slavin S, Nagler A, Naparstek E, Kapelushnik Y, Aker M, Cividalli G, Varadi G, Kirschbaum M, Ackerstein A, Samuel S, Amar A, Brautbar C, Ben-Tal O, Eldor A, Or R. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood. 1998 Feb 1;91(3):756-63. link to original article contains dosing details in manuscript PubMed
  2. Schetelig J, Thiede C, Bornhauser M, Schwerdtfeger R, Kiehl M, Beyer J, Sayer HG, Kroger N, Hensel M, Scheffold C, Held TK, Hoffken K, Ho AD, Kienast J, Neubauer A, Zander AR, Fauser AA, Ehninger G, Siegert W; Cooperative German Transplant Study Group. Evidence of a graft-versus-leukemia effect in chronic lymphocytic leukemia after reduced-intensity conditioning and allogeneic stem-cell transplantation: the Cooperative German Transplant Study Group. J Clin Oncol. 2003 Jul 15;21(14):2747-53. link to original article contains reference to protocol PubMed
  3. IFM99-03: Garban F, Attal M, Michallet M, Hulin C, Bourhis JH, Yakoub-Agha I, Lamy T, Marit G, Maloisel F, Berthou C, Dib M, Caillot D, Deprijck B, Ketterer N, Harousseau JL, Sotto JJ, Moreau P. Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma. Blood. 2006 May 1;107(9):3474-80. Epub 2006 Jan 5. link to original article contains dosing details in manuscript PubMed
    1. Pooled update: Moreau P, Garban F, Attal M, Michallet M, Marit G, Hulin C, Benboubker L, Doyen C, Mohty M, Yakoub-Agha I, Leyvraz S, Casassus P, Avet-Loiseau H, Garderet L, Mathiot C, Harousseau JL; IFM. Long-term follow-up results of IFM99-03 and IFM99-04 trials comparing nonmyeloablative allotransplantation with autologous transplantation in high-risk de novo multiple myeloma. Blood. 2008 Nov 1;112(9):3914-5. link to original article PubMed
  4. ITT 08-01: Mohty M, Malard F, Blaise D, Milpied N, Furst S, Tabrizi R, Guillaume T, Vigouroux S, El-Cheikh J, Delaunay J, Le Gouill S, Moreau P, Labopin M, Chevallier P. Reduced-toxicity conditioning with fludarabine, once-daily intravenous busulfan, and antithymocyte globulins prior to allogeneic stem cell transplantation: results of a multicenter prospective phase 2 trial. Cancer. 2015 Feb 15;121(4):562-9. Epub 2014 Oct 3. Erratum in: Cancer. 2015 Mar 1;121(5):800. link to original article contains dosing details in manuscript PubMed NCT00841724
  5. CALGB 100103: Devine SM, Owzar K, Blum W, Mulkey F, Stone RM, Hsu JW, Champlin RE, Chen YB, Vij R, Slack J, Soiffer RJ, Larson RA, Shea TC, Hars V, Sibley AB, Giralt S, Carter S, Horowitz MM, Linker C, Alyea EP. Phase II study of allogeneic transplantation for older patients with acute myeloid leukemia in first complete remission using a reduced-intensity conditioning regimen: results from Cancer and Leukemia Group B 100103 (Alliance for Clinical Trials in Oncology)/Blood and Marrow Transplant Clinical Trial Network 0502. J Clin Oncol. 2015 Dec 10;33(35):4167-75. Epub 2015 Nov 2. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00070135
  6. MC-FludT.14/L: Beelen DW, Trenschel R, Stelljes M, Groth C, Masszi T, Reményi P, Wagner-Drouet EM, Hauptrock B, Dreger P, Luft T, Bethge W, Vogel W, Ciceri F, Peccatori J, Stölzel F, Schetelig J, Junghanß C, Grosse-Thie C, Michallet M, Labussiere-Wallet H, Schaefer-Eckart K, Dressler S, Grigoleit GU, Mielke S, Scheid C, Holtick U, Patriarca F, Medeot M, Rambaldi A, Micò MC, Niederwieser D, Franke GN, Hilgendorf I, Winkelmann NR, Russo D, Socié G, Peffault de Latour R, Holler E, Wolff D, Glass B, Casper J, Wulf G, Menzel H, Basara N, Bieniaszewska M, Stuhler G, Verbeek M, Grass S, Iori AP, Finke J, Benedetti F, Pichlmeier U, Hemmelmann C, Tribanek M, Klein A, Mylius HA, Baumgart J, Dzierzak-Mietla M, Markiewicz M. Treosulfan or busulfan plus fludarabine as conditioning treatment before allogeneic haemopoietic stem cell transplantation for older patients with acute myeloid leukaemia or myelodysplastic syndrome (MC-FludT.14/L): a randomised, non-inferiority, phase 3 trial. Lancet Haematol. 2020 Jan;7(1):e28-e39. Epub 2019 Oct 9. link to original article contains dosing details in abstract PubMed NCT00822393
  7. CUTALLO: de Masson A, Beylot-Barry M, Ram-Wolff C, Mear JB, Dalle S, d'Incan M, Ingen-Housz-Oro S, Orvain C, Abraham J, Dereure O, Charbonnier A, Cornillon J, Longvert C, Barete S, Boulinguez S, Wierzbicka-Hainaut E, Aubin F, Rubio MT, Bernard M, Schmidt-Tanguy A, Houot R, Pham-Ledard A, Michonneau D, Brice P, Labussière-Wallet H, Bouaziz JD, Grange F, Moins-Teisserenc H, Jondeau K, Michel L, Mourah S, Battistella M, Daguindau E, Loschi M, Picard A, Franck N, Maillard N, Huynh A, Nguyen S, Marçais A, Chaby G, Ceballos P, Le Corre Y, Maury S, Bay JO, Adamski H, Bachy E, Forcade E, Socié G, Bagot M, Chevret S, Peffault de Latour R; CUTALLO Investigators; Groupe Français d'Etude des Lymphomes Cutanés; Société Française de Greffe de Moëlle et Thérapie Cellulaire. Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023 Jun 10;401(10392):1941-1950. Epub 2023 Apr 24. link to original article contains dosing details in supplement PubMed NCT02520908

Busulfan, Fludarabine, Ibritumomab tiuxetan

Regimen

Study Evidence
Bouabdallah et al. 2015 (ZEVALLO) Phase 2

Chemotherapy

Targeted therapy

Radioconjugate therapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. ZEVALLO: Bouabdallah K, Furst S, Asselineau J, Chevalier P, Tournilhac O, Ceballos P, Vigouroux S, Tabrizi R, Doussau A, Bouabdallah R, Mohty M, Le Gouill S, Blaise D, Milpied N. 90Y-ibritumomab tiuxetan, fludarabine, busulfan and antithymocyte globulin reduced-intensity allogeneic transplant conditioning for patients with advanced and high-risk B-cell lymphomas. Ann Oncol. 2015 Jan;26(1):193-8. Epub 2014 Oct 30. link to original article contains dosing details in manuscript PubMed NCT00607854

Busulfan, Fludarabine, Thiotepa

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
de Masson et al. 2023 (CUTALLO) 2016-06-01 to 2022-03-03 Propensity score analysis (E-esc) No transplant Superior PFS (primary endpoint)
Median PFS: 9 vs 3 mo
(HR 0.38, 95% CI 0.21-0.69)

Diseases Studied: Cutaneous T-cell lymphoma

Note: this preparative regimen was intended for haploidentical HSCT.

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. CUTALLO: de Masson A, Beylot-Barry M, Ram-Wolff C, Mear JB, Dalle S, d'Incan M, Ingen-Housz-Oro S, Orvain C, Abraham J, Dereure O, Charbonnier A, Cornillon J, Longvert C, Barete S, Boulinguez S, Wierzbicka-Hainaut E, Aubin F, Rubio MT, Bernard M, Schmidt-Tanguy A, Houot R, Pham-Ledard A, Michonneau D, Brice P, Labussière-Wallet H, Bouaziz JD, Grange F, Moins-Teisserenc H, Jondeau K, Michel L, Mourah S, Battistella M, Daguindau E, Loschi M, Picard A, Franck N, Maillard N, Huynh A, Nguyen S, Marçais A, Chaby G, Ceballos P, Le Corre Y, Maury S, Bay JO, Adamski H, Bachy E, Forcade E, Socié G, Bagot M, Chevret S, Peffault de Latour R; CUTALLO Investigators; Groupe Français d'Etude des Lymphomes Cutanés; Société Française de Greffe de Moëlle et Thérapie Cellulaire. Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023 Jun 10;401(10392):1941-1950. Epub 2023 Apr 24. link to original article contains dosing details in supplement PubMed NCT02520908

Clofarabine & Melphalan

Regimen

Study Evidence
Middeke et al. 2015 (BRIDGE) Phase 2

Limited details are available in the abstract. Treatment is meant to be given during aplasia.

Preceding treatment

Chemotherapy

Immunotherapy

One course

References

  1. BRIDGE: Middeke JM, Herbst R, Parmentier S, Bug G, Hänel M, Stuhler G, Schäfer-Eckart K, Rösler W, Klein S, Bethge W, Bitz U, Büttner B, Knoth H, Alakel N, Schaich M, Morgner A, Kramer M, Sockel K, von Bonin M, Stölzel F, Platzbecker U, Röllig C, Thiede C, Ehninger G, Bornhäuser M, Schetelig J. Clofarabine salvage therapy before allogeneic hematopoietic stem cell transplantation in patients with relapsed or refractory AML: results of the BRIDGE trial. Leukemia. 2016 Feb;30(2):261-7. Epub 2015 Aug 18. link to original article contains dosing details in abstract PubMed

Cyclophosphamide, Fludarabine, Thiotepa

Regimen

Study Evidence
Corradini et al. 2002 Non-randomized

Chemotherapy

  • Cyclophosphamide (Cytoxan) 30 mg/kg IV once per day on days -4 & -3
  • Fludarabine (Fludara) 30 mg/m2 IV once per day on days -4 & -3, given 4 hours after cyclophosphamide
  • Thiotepa (Thioplex) by the following age-based criteria:
    • Younger than 45 years old: 7.5 mg/kg IV once every 12 hours on day -6 (total dose 15 mg/kg)
    • 45 to 60 years old: 5 mg/kg IV once every 12 hours on day -6 (total dose 10 mg/kg)
    • Older than 60 years old: 2.5 mg/kg IV once every 12 hours on day -6 (total dose 5 mg/kg)

Immunotherapy

One course

References

  1. Corradini P, Tarella C, Olivieri A, Gianni AM, Voena C, Zallio F, Ladetto M, Falda M, Lucesole M, Dodero A, Ciceri F, Benedetti F, Rambaldi A, Sajeva MR, Tresoldi M, Pileri A, Bordignon C, Bregni M. Reduced-intensity conditioning followed by allografting of hematopoietic cells can produce clinical and molecular remissions in patients with poor-risk hematologic malignancies. Blood. 2002 Jan 1;99(1):75-82. link to original article contains dosing details in manuscript PubMed

Cyclophosphamide & Fludarabine (FC)

FC: Fludarabine & Cyclophosphamide
FluCy: Fludarabine & Cyclophosphamide

Regimen variant #1, 150/2500

Study Evidence
Dreger et al. 2010 (GCLLSG CLL3X) Phase 2

Chemotherapy

GVHD prophylaxis

  • ATG-Fresenius by the following donor-based criteria:
    • Unrelated donors: 10 mg/kg/day IV on days -4 to -1 (4 consecutive days)

Immunotherapy

One course


Regimen variant #2, 125/120

Study Evidence
Childs et al. 2000 Non-randomized, fewer than 20 pts

Chemotherapy

Immunotherapy

One course

References

  1. Childs R, Chernoff A, Contentin N, Bahceci E, Schrump D, Leitman S, Read EJ, Tisdale J, Dunbar C, Linehan WM, Young NS, Clave E, Epperson D, Mayo V, Barrett AJ. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med. 2000 Sep 14;343(11):750-8. link to original article contains dosing details in manuscript PubMed
  2. GCLLSG CLL3X: Dreger P, Döhner H, Ritgen M, Böttcher S, Busch R, Dietrich S, Bunjes D, Cohen S, Schubert J, Hegenbart U, Beelen D, Zeis M, Stadler M, Hasenkamp J, Uharek L, Scheid C, Humpe A, Zenz T, Winkler D, Hallek M, Kneba M, Schmitz N, Stilgenbauer S; German CLL Study Group. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial. Blood. 2010 Oct 7;116(14):2438-47. Epub 2010 Jul 1. link to original article contains dosing details in manuscript PubMed NCT00281983
    1. Update: Dreger P, Schnaiter A, Zenz T, Böttcher S, Rossi M, Paschka P, Bühler A, Dietrich S, Busch R, Ritgen M, Bunjes D, Zeis M, Stadler M, Uharek L, Scheid C, Hegenbart U, Hallek M, Kneba M, Schmitz N, Döhner H, Stilgenbauer S. TP53, SF3B1, and NOTCH1 mutations and outcome of allotransplantation for chronic lymphocytic leukemia: six-year follow-up of the GCLLSG CLL3X trial. Blood. 2013 Apr 18;121(16):3284-8. Epub 2013 Feb 22. link to original article PubMed
    2. Update: Krämer I, Stilgenbauer S, Dietrich S, Böttcher S, Zeis M, Stadler M, Bittenbring J, Uharek L, Scheid C, Hegenbart U, Ho A, Hallek M, Kneba M, Schmitz N, Döhner H, Dreger P. Allogeneic hematopoietic cell transplantation for high-risk CLL: 10-year follow-up of the GCLLSG CLL3X trial. Blood. 2017 Sep 21;130(12):1477-1480. Epub 2017 Jul 17. link to original article PubMed

FBM

FBM: Fludarabine, BCNU (Carmustine), Melphalan

Regimen variant #1

Study Dates of enrollment Evidence
Marks et al. 2008 1998-2003 Phase 2

Note: this variant is intended for patients younger than 55 years of age.

Chemotherapy

Immunotherapy

One course


Regimen variant #2

Study Dates of enrollment Evidence
Marks et al. 2008 1998-2003 Phase 2

Note: this variant is intended for patients 55 years of age and older.

Chemotherapy

Immunotherapy

One course

References

  1. Marks R, Potthoff K, Hahn J, Ihorst G, Bertz H, Spyridonidis A, Holler E, Finke JM. Reduced-toxicity conditioning with fludarabine, BCNU, and melphalan in allogeneic hematopoietic cell transplantation: particular activity against advanced hematologic malignancies. Blood. 2008 Jul 15;112(2):415-25. Epub 2008 May 1. link to original article contains dosing details in manuscript PubMed

FCR

FCR: Fludarabine, Cyclophosphamide, Rituximab

Regimen

Study Dates of enrollment Evidence
Khouri et al. 2001 (MDACC ID01-233) 1997-2000 Phase 2

Details are best described in the 2008 update.

Chemotherapy

Targeted therapy

  • Rituximab (Rituxan) 375 mg/m2 IV once on day -13, then 1000 mg/m2 IV once per day on days -6, +1, +8

Immunotherapy

GVHD prophylaxis

  • Antithymocyte globulin, horse ATG (Atgam) by the following donor-based criteria:
    • Matched unrelated donor: 15 mg/kg IV once per day on days -5 to -3
  • Tacrolimus (Prograf) adjusted to level of 5 to 10 ng/mL for 6 months in patients in remission
  • Methotrexate (MTX) by the following donor-based criteria:
    • Related donors: 5 mg/m2 IV once per day on days +1, +3, +6
    • Unrelated donors: 5 mg/m2 IV once per day on days +1, +3, +6, +11

One course

References

  1. MDACC ID01-233: Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. link to original article PubMed NCT00048737
    1. Update: Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. link to original article contains dosing details in manuscript link to PMC article PubMed
    2. Update: Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. link to original article contains dosing details in manuscript link to PMC article PubMed

Fludarabine & TBI

Regimen variant #1

Study Dates of enrollment Evidence Comparator Comparative Efficacy Non-relapse mortality
Bornhäuser et al. 2012 (9005-2003) 2004-2009 Phase 3 (E-switch-ic) Cyclophosphamide & TBI Did not meet primary endpoint of NRM

Chemotherapy

Radiotherapy

Immunotherapy

One course


Regimen variant #2, low-dose TBI

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Sorror et al. 2005 1997-2003 Phase 2
Gyukocza et al. 2010 1998-2008 Non-randomized
Maris et al. 2003 2000-2001 Phase 2
Björkstrand et al. 2011 (EBMT-NMAM2000) 2001-2005 Non-randomized part of RCT
Kornblit et al. 2013 (FHCRC 1813.00) 2003-2011 Phase 3 (E-esc) Low-dose TBI Might have superior OS36 (primary endpoint)

Details are best described in Maris et al. 2003.

Chemotherapy

Radiotherapy

Immunotherapy

GVHD prophylaxis

  • Cyclosporine 6.25 mg/kg PO twice per day starting 4 to 6 hours after transplant, tapered at day 100 over 80 days (if no GVHD)
  • Mycophenolate mofetil (CellCept) 15 mg/kg PO twice per day starting 4 to 6 hours after transplant, tapered at day 40 over 56 days (if no GVHD)

One course

References

  1. Maris MB, Niederwieser D, Sandmaier BM, Storer B, Stuart M, Maloney D, Petersdorf E, McSweeney P, Pulsipher M, Woolfrey A, Chauncey T, Agura E, Heimfeld S, Slattery J, Hegenbart U, Anasetti C, Blume K, Storb R. HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies. Blood. 2003 Sep 15;102(6):2021-30. Epub 2003 Jun 5. link to original article contains dosing details in manuscript PubMed
  2. Sorror ML, Maris MB, Sandmaier BM, Storer BE, Stuart MJ, Hegenbart U, Agura E, Chauncey TR, Leis J, Pulsipher M, McSweeney P, Radich JP, Bredeson C, Bruno B, Langston A, Loken MR, Al-Ali H, Blume KG, Storb R, Maloney DG. Hematopoietic cell transplantation after nonmyeloablative conditioning for advanced chronic lymphocytic leukemia. J Clin Oncol. 2005 Jun 1;23(16):3819-29. Epub 2005 Apr 4. link to original article contains dosing details in manuscript PubMed
    1. Update: Sorror ML, Storer BE, Sandmaier BM, Maris M, Shizuru J, Maziarz R, Agura E, Chauncey TR, Pulsipher MA, McSweeney PA, Wade JC, Bruno B, Langston A, Radich J, Niederwieser D, Blume KG, Storb R, Maloney DG. Five-year follow-up of patients with advanced chronic lymphocytic leukemia treated with allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. J Clin Oncol. 2008 Oct 20;26(30):4912-20. Epub 2008 Sep 15. link to original article link to PMC article PubMed
  3. Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. Epub 2010 May 3. link to original article contains dosing details in manuscript link to PMC article PubMed
  4. EBMT-NMAM2000: Björkstrand B, Iacobelli S, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Musto P, Beksac M, Bosi A, Milone G, Corradini P, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Gahrton G. Tandem autologous/reduced-intensity conditioning allogeneic stem-cell transplantation versus autologous transplantation in myeloma: long-term follow-up. J Clin Oncol. 2011 Aug 1;29(22):3016-22. Epub 2011 Jul 5. Erratum in: J Clin Oncol. 2011 Sep 20;29(27):3721. link to original article contains dosing details in abstract PubMed
    1. Update: Gahrton G, Iacobelli S, Björkstrand B, Hegenbart U, Gruber A, Greinix H, Volin L, Narni F, Carella AM, Beksac M, Bosi A, Milone G, Corradini P, Schönland S, Friberg K, van Biezen A, Goldschmidt H, de Witte T, Morris C, Niederwieser D, Garderet L, Kröger N; EBMT Chronic Malignancies Working Party Plasma Cell Disorders Subcommittee. Autologous/reduced-intensity allogeneic stem cell transplantation vs autologous transplantation in multiple myeloma: long-term results of the EBMT-NMAM2000 study. Blood. 2013 Jun 20;121(25):5055-63. Epub 2013 Mar 12. link to original article PubMed
  5. 9005-2003: Bornhäuser M, Kienast J, Trenschel R, Burchert A, Hegenbart U, Stadler M, Baurmann H, Schäfer-Eckart K, Holler E, Kröger N, Schmid C, Einsele H, Kiehl MG, Hiddemann W, Schwerdtfeger R, Buchholz S, Dreger P, Neubauer A, Berdel WE, Ehninger G, Beelen DW, Schetelig J, Stelljes M. Reduced-intensity conditioning versus standard conditioning before allogeneic haemopoietic cell transplantation in patients with acute myeloid leukaemia in first complete remission: a prospective, open-label randomised phase 3 trial. Lancet Oncol. 2012 Oct;13(10):1035-44. Epub 2012 Sep 7. link to original article contains dosing details in manuscript PubMed NCT00150878
  6. FHCRC 1813.00: Kornblit B, Maloney DG, Storb R, Storek J, Hari P, Vucinic V, Maziarz RT, Chauncey TR, Pulsipher MA, Bruno B, Petersen FB, Bethge WA, Hübel K, Bouvier ME, Fukuda T, Storer BE, Sandmaier BM. Fludarabine and 2-Gy TBI is superior to 2 Gy TBI as conditioning for HLA-matched related hematopoietic cell transplantation: a phase III randomized trial. Biol Blood Marrow Transplant. 2013 Sep;19(9):1340-7. Epub 2013 Jun 11. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00075478

Fludarabine, Cyclophosphamide, TBI for dUCB or haploidentical transplant

dUCB: double Umbilical Cord Blood

Regimen variant #1, dUCB transplantation

Study Dates of enrollment Evidence
Brunstein et al. 2011 (BMT CTN 0604) 2009-01 to 2010-03 Phase 2

Chemotherapy

Radiotherapy

Immunotherapy

Supportive therapy

  • Mesna (Mesnex) (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
  • Filgrastim (Neupogen) 5 mcg/kg SC once per day, starting on day +1, continued until ANC greater than or equal to 2000/μL for 3 consecutive days

GVHD prophylaxis

  • Mycophenolate mofetil (CellCept) by the following weight-based criteria:
    • More than 50 kg: 1000 mg (route not specified) every 8 hours, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
    • Less than 50 kg: 15 mg/kg (route not specified) every 8 hours, starting on day -3 "and continuing until day +30 or 7 days after engraftment, whichever was later"
  • Cyclosporine (route not specified) with a goal trough of 200 to 400 ng/mL (starting date not specified) until day +100. Patients without GVHD had their dose tapered by 10% each week starting on day +101, with discontinuation of cyclosporine A around day +180 to +200.
  • Tacrolimus (Prograf) (route not specified) with a goal trough level of 5 to 10 ng/mL could be substituted for cyclosporine.

One course


Regimen variant #2, Haploidentical

Study Dates of enrollment Evidence
Brunstein et al. 2011 (BMT CTN 0603) 2009-01 to 2010-03 Phase 2

Chemotherapy

Radiotherapy

Immunotherapy

Supportive therapy

  • Mesna (Mesnex) (dose/route/schedule not specified) and "vigorous IV hydration for uroprotection."
  • Filgrastim (Neupogen) 5 mcg/kg SC once per day, starting on day +5, continued until ANC greater than or equal to 1000/μL for 3 consecutive days

GVHD prophylaxis

  • Cyclophosphamide (Cytoxan) 50 mg/kg IBW IV over 1 to 2 hours once per day on days +3 & +4, started 60 to 72 hours after marrow infusion
  • Mycophenolate mofetil (CellCept) 15 mg/kg (maximum daily dose of 3000 mg; route not specified) every 8 hours, starting on day +5, continued until day +35 or longer at physician discretion if active GVHD was present
  • Tacrolimus (Prograf) (route not specified) with a goal trough level of 5 to 10 ng/mL, starting on day +5, continued until day +180

One course

References

  1. BMT CTN 0603: Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV; BMT CTN. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. Epub 2011 Apr 28. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00849147
  2. BMT CTN 0604: Brunstein CG, Fuchs EJ, Carter SL, Karanes C, Costa LJ, Wu J, Devine SM, Wingard JR, Aljitawi OS, Cutler CS, Jagasia MH, Ballen KK, Eapen M, O'Donnell PV; BMT CTN. Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts. Blood. 2011 Jul 14;118(2):282-8. Epub 2011 Apr 28. link to original article contains dosing details in manuscript link to PMC article PubMed NCT00864227
  3. BMT CTN 0501: Wagner JE Jr, Eapen M, Carter S, Wang Y, Schultz KR, Wall DA, Bunin N, Delaney C, Haut P, Margolis D, Peres E, Verneris MR, Walters M, Horowitz MM, Kurtzberg J; Blood and Marrow Transplant Clinical Trials Network. One-unit versus two-unit cord-blood transplantation for hematologic cancers. N Engl J Med. 2014 Oct 30;371(18):1685-94. link to original article link to PMC article PubMed NCT00412360
  4. BMT CTN 1101: Fuchs EJ, O'Donnell PV, Eapen M, Logan B, Antin JH, Dawson P, Devine S, Horowitz MM, Horwitz ME, Karanes C, Leifer E, Magenau JM, McGuirk JP, Morris LE, Rezvani AR, Jones RJ, Brunstein CG. Double unrelated umbilical cord blood vs HLA-haploidentical bone marrow transplantation: the BMT CTN 1101 trial. Blood. 2021 Jan 21;137(3):420-428. link to original article link to PMC article PubMed NCT01597778
    1. QoL analysis: El Jurdi N, Martens MJ, Brunstein CG, O'Donnell P, Lee SJ, D'Souza A, Logan B, Hong S, Singh AK, Sandhu K, Shapiro RM, Horowitz MM, Hamilton BK. Health-Related Quality of Life in Double Umbilical Cord Blood versus Haploidentical Marrow Transplantation: A Quality of Life Analysis Report of BMT CTN 1101. Transplant Cell Ther. 2023 Jul;29(7):467.e1-467.e5. Epub 2023 Apr 22. link to original article link to PMC article PubMed

Fludarabine & Melphalan

Flu-Mel: Fludarabine & Melphalan

Regimen variant #1, 90/140

Study Dates of enrollment Evidence Comparator Comparative Efficacy
de Masson et al. 2023 (CUTALLO) 2016-06-01 to 2022-03-03 Propensity score analysis (E-esc) No transplant Superior PFS (primary endpoint)
Median PFS: 9 vs 3 mo
(HR 0.38, 95% CI 0.21-0.69)

Diseases Studied: Cutaneous T-cell lymphoma

Chemotherapy

Immunotherapy

GVHD prophylaxis

  • Cyclosporine started on day -1, tapered on day +90 if no GVHD
  • Methotrexate (MTX) 15 mg/m2 IV once on day +1, then 10 mg/m2 IV once per day on days +3, +6, +11

One course


Regimen variant #2, 132/140

Study Dates of enrollment Evidence
Anderlini et al. 2008 2001-2005 Phase 2

Diseases Studied: Classical Hodgkin lymphoma

Chemotherapy

Immunotherapy

GVHD prophylaxis

  • ATG (type not specified) by the following donor-based criteria:
    • Matched unrelated donor: 2 mg/kg IV once per day on days -4 to -2
  • Tacrolimus (Prograf) IV starting on day -2, dosed to achieve serum levels 4 to 12 ng/mL and switched to PO as soon as possible. Continued for at least 6 months and then "tapered off" (instructions not given).
  • Methotrexate (MTX) 5 mg/m2 IV once per day on days +1, +3, +6 (extra dose on day +11 for MUD recipients)

One course


Regimen variant #3, 150/140

Study Dates of enrollment Evidence
Alvarez et al. 2006 1999-06 to 2004-01 Prospective
Sureda et al. 2011 (HDR-ALLO) NR Phase 2

Diseases Studied: Classical Hodgkin lymphoma
Note: Alvarez et al. 2006 began CsA on day -1 and did not give day +11 MTX.

Chemotherapy

Immunotherapy

GVHD prophylaxis

  • Recipients of stem cells from matched unrelated donors received:
  • Cyclosporine starting on day -2 at 1.5 mg/kg IV twice per day
    • If no acute GVHD of grade 2 or more, cyclosporine A is tapered down by 10% per week starting on day +90 with planned discontinuation by day +150 (Alvarez et al. 2006) or +180 (HDR-ALLO).
  • Methotrexate (MTX) 10 mg/m2 IV once per day on days +1, +3, +6, +11

One course


Regimen variant #4, 150/40, with alemtuzumab

Study Dates of enrollment Evidence
Peggs et al. 2005 1997-10-3 to 2003-08-21 Non-randomized

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. Peggs KS, Hunter A, Chopra R, Parker A, Mahendra P, Milligan D, Craddock C, Pettengell R, Dogan A, Thomson KJ, Morris EC, Hale G, Waldmann H, Goldstone AH, Linch DC, Mackinnon S. Clinical evidence of a graft-versus-Hodgkin's-lymphoma effect after reduced-intensity allogeneic transplantation. Lancet. 2005 Jun 4-10;365(9475):1934-41. link to original article contains dosing details in manuscript PubMed
  2. Alvarez I, Sureda A, Caballero MD, Urbano-Ispizua A, Ribera JM, Canales M, García-Conde J, Sanz G, Arranz R, Bernal MT, de la Serna J, Díez JL, Moraleda JM, Rubió-Félix D, Xicoy B, Martínez C, Mateos MV, Sierra J. Nonmyeloablative stem cell transplantation is an effective therapy for refractory or relapsed Hodgkin lymphoma: results of a Spanish prospective cooperative protocol. Biol Blood Marrow Transplant. 2006 Feb;12(2):172-83. link to original article contains dosing details in manuscript PubMed
  3. Anderlini P, Saliba R, Acholonu S, Giralt SA, Andersson B, Ueno NT, Hosing C, Khouri IF, Couriel D, de Lima M, Qazilbash MH, Pro B, Romaguera J, Fayad L, Hagemeister F, Younes A, Munsell MF, Champlin RE. Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated MD Anderson Cancer Center experience. Haematologica. 2008 Feb;93(2):257-64. Epub 2008 Jan 26. link to original article contains dosing details in manuscript link to PMC article PubMed
  4. HDR-ALLO: Sureda A, Canals C, Arranz R, Caballero D, Ribera JM, Brune M, Passweg J, Martino R, Valcárcel D, Besalduch J, Duarte R, León A, Pascual MJ, García-Noblejas A, López Corral L, Xicoy B, Sierra J, Schmitz N; GEL/TAMO. Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin's lymphoma: results of the HDR-ALLO study - a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Haematologica. 2012 Feb;97(2):310-7. Epub 2011 Oct 11. link to original article contains dosing details in abstract link to PMC article PubMed
  5. CUTALLO: de Masson A, Beylot-Barry M, Ram-Wolff C, Mear JB, Dalle S, d'Incan M, Ingen-Housz-Oro S, Orvain C, Abraham J, Dereure O, Charbonnier A, Cornillon J, Longvert C, Barete S, Boulinguez S, Wierzbicka-Hainaut E, Aubin F, Rubio MT, Bernard M, Schmidt-Tanguy A, Houot R, Pham-Ledard A, Michonneau D, Brice P, Labussière-Wallet H, Bouaziz JD, Grange F, Moins-Teisserenc H, Jondeau K, Michel L, Mourah S, Battistella M, Daguindau E, Loschi M, Picard A, Franck N, Maillard N, Huynh A, Nguyen S, Marçais A, Chaby G, Ceballos P, Le Corre Y, Maury S, Bay JO, Adamski H, Bachy E, Forcade E, Socié G, Bagot M, Chevret S, Peffault de Latour R; CUTALLO Investigators; Groupe Français d'Etude des Lymphomes Cutanés; Société Française de Greffe de Moëlle et Thérapie Cellulaire. Allogeneic transplantation in advanced cutaneous T-cell lymphomas (CUTALLO): a propensity score matched controlled prospective study. Lancet. 2023 Jun 10;401(10392):1941-1950. Epub 2023 Apr 24. link to original article contains dosing details in supplement PubMed NCT02520908

Low-dose TBI

TBI: Total Body Irradiation

Regimen

Study Evidence
Gyukocza et al. 2010 Non-randomized

Radiotherapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. Gyurkocza B, Storb R, Storer BE, Chauncey TR, Lange T, Shizuru JA, Langston AA, Pulsipher MA, Bredeson CN, Maziarz RT, Bruno B, Petersen FB, Maris MB, Agura E, Yeager A, Bethge W, Sahebi F, Appelbaum FR, Maloney DG, Sandmaier BM. Nonmyeloablative allogeneic hematopoietic cell transplantation in patients with acute myeloid leukemia. J Clin Oncol. 2010 Jun 10;28(17):2859-67. Epub 2010 May 3. link to original article contains dosing details in manuscript link to PMC article PubMed

TLI

TLI: Total Lymphocyte Irradiation

Regimen

Study Dates of enrollment Evidence
Lowsky et al. 2005 2001-12-28 to 2004-12-01 Non-randomized
Kohrt et al. 2009 (BMT153) 2001-12-28 to 2007-09-06 Non-randomized

Note: the schedule for TLI in BMT153 is slightly different, although the manuscript states that the protocol from Lowsky et al. 2005 was followed. See paper for details.

Radiotherapy

  • TLI 800 cGy once per day on days -11 to -1 (10 fractions)

GVHD prophylaxis

Immunotherapy

One course

References

  1. Lowsky R, Takahashi T, Liu YP, Dejbakhsh-Jones S, Grumet FC, Shizuru JA, Laport GG, Stockerl-Goldstein KE, Johnston LJ, Hoppe RT, Bloch DA, Blume KG, Negrin RS, Strober S. Protective conditioning for acute graft-versus-host disease. N Engl J Med. 2005 Sep 29;353(13):1321-31. Erratum in: N Engl J Med. 2006 Feb 23;354(8):884. link to original article contains dosing details in manuscript PubMed
  2. BMT153: Kohrt HE, Turnbull BB, Heydari K, Shizuru JA, Laport GG, Miklos DB, Johnston LJ, Arai S, Weng WK, Hoppe RT, Lavori PW, Blume KG, Negrin RS, Strober S, Lowsky R. TLI and ATG conditioning with low risk of graft-versus-host disease retains antitumor reactions after allogeneic hematopoietic cell transplantation from related and unrelated donors. Blood. 2009 Jul 30;114(5):1099-109. Epub 2009 May 7. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00185640

(90)YFC

(90)YFC: Ibritumomab tiuxetan, Fludarabine, Cyclophosphamide

Regimen

Study Dates of enrollment Evidence
Khouri et al. 2001 (MDACC ID01-233) 1997-2000 Phase 2

Note: this regimen is specifically addressed in the 2012 update.

Targeted therapy

Radioconjugate therapy

Chemotherapy

Immunotherapy

GVHD prophylaxis

One course

References

  1. MDACC ID01-233: Khouri IF, Saliba RM, Giralt SA, Lee MS, Okoroji GJ, Hagemeister FB, Korbling M, Younes A, Ippoliti C, Gajewski JL, McLaughlin P, Anderlini P, Donato ML, Cabanillas FF, Champlin RE. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood. 2001 Dec 15;98(13):3595-9. link to original article PubMed NCT00048737
    1. Update: Khouri IF, McLaughlin P, Saliba RM, Hosing C, Korbling M, Lee MS, Medeiros LJ, Fayad L, Samaniego F, Alousi A, Anderlini P, Couriel D, de Lima M, Giralt S, Neelapu SS, Ueno NT, Samuels BI, Hagemeister F, Kwak LW, Champlin RE. Eight-year experience with allogeneic stem cell transplantation for relapsed follicular lymphoma after nonmyeloablative conditioning with fludarabine, cyclophosphamide, and rituximab. Blood. 2008 Jun 15;111(12):5530-6. Epub 2008 Apr 14. Erratum in: Blood. 2009 Feb 12;113(7):1613. link to original article contains dosing details in manuscript link to PMC article PubMed
    2. Update: Khouri IF, Saliba RM, Erwin WD, Samuels BI, Korbling M, Medeiros LJ, Valverde R, Alousi AM, Anderlini P, Bashir Q, Ciurea S, Gulbis AM, de Lima M, Hosing C, Kebriaei P, Popat UR, Fowler N, Neelapu SS, Samaniego F, Champlin RE, Macapinlac HA. Nonmyeloablative allogeneic transplantation with or without 90yttrium ibritumomab tiuxetan is potentially curative for relapsed follicular lymphoma: 12-year results. Blood. 2012 Jun 28;119(26):6373-8. Epub 2012 May 14. link to original article contains dosing details in manuscript link to PMC article PubMed