Bone marrow transplantation
July 20, 2026 · via Europe PMC
Allogeneic hematopoietic cell transplantation from haploidentical donors with total body irradiation versus chemo-based regimens for adult AML patients in first complete remission. A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT).
Maffini E, Labopin M, Raiola AM, +14 more, Mohty M.
AI summary — for doctors, generated from the abstract only
For adults with AML in first remission undergoing haploidentical transplant, TBI-based conditioning did not show a survival advantage over chemotherapy-based regimens.
What was studied
Retrospective EBMT ALWP analysis of 2309 patients (median age 56.8) transplanted 2010-2022, comparing TBI versus chemotherapy conditioning stratified by low versus intermediate/high conditioning intensity.
Key findings
- With low intensity, TBI had higher relapse (HR 1.49, 95% CI 1.03-2.16) but lower NRM (HR 0.56)
- With intermediate/high intensity, TBI had higher NRM (HR 1.71), inferior OS (HR 1.61) and inferior GRFS (HR 1.43)
- Overall, TBI is feasible but not associated with a survival advantage
Clinical relevance
Suggests TBI should not be assumed superior in haploidentical AML transplantation; regimen choice should be individualised.
Who should care
Limitations
Retrospective registry data with possible confounding by center preferences and patient selection; the authors call for prospective trials.
No survival benefit of TBI over chemotherapy-only conditioning was seen, with trade-offs depending on intensity.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Adults with acute myeloid leukaemia (AML) receiving T-cell replete hematopoietic cell transplantation (HCT) from haploidentical donors are increasing. It is unknown whether a total body irradiation (TBI)-based regimen is associated with better survival than a chemotherapy (chemo)-based regimen. This is a retrospective analysis of AML patients in first complete remission who received a HCT from a haploidentical donor, from 2010 to 2022, reported to the ALWP of the EBMT database. Patients were divided into TBI vs. chemo-based regimens and stratified by transplant conditioning intensity (TCI): low (1-2) vs. intermediate/high (2.5-6). A total of 2309 patients (median age 56.8 years, range 18-82) were included. For patients with low TCI, multivariate analysis confirmed higher disease relapse with TBI (HR 1.49, 95% CI 1.03-2.16, p = 0.033) with respect to chemo, but lower NRM (HR 0.56, 95% CI 0.36-0.89, p = 0.013). In TCI intermediate/high, TBI was associated with a higher risk of NRM (HR 1.71, 95% CI 1.07-2.74, p = 0.026), inferior OS (HR 1.61, 95% CI 1.08-2.42, p = 0.02) and GRFS (HR 1.43, 95% CI 1.03-1.95, p = 0.034). The use of TBI in AML transplanted from haploidentical donors is feasible, although it does not appear to be associated with a survival advantage compared to chemotherapy-only regimens. Prospective clinical trials are warranted.
DOI
10.1038/s41409-026-02988-w
PMID
42477157
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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