A Novel Modified Bu/Vp16/cy/Flu/Ara‐C Conditioning Regimen Enhances Outcomes for High‐Risk Acute Lymphoblastic Leukemia Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

作者：Xinyu Zhao, Yongfang Yao, Yanan Sun, Ziwei Xu, Aiguo Liu, Xin Dong, Hao Wang · 发表于：Cancer Medicine · 年份：2026 · DOI：10.1002/cam4.71669 · 被引用次数：1 · 研究领域：Acute Lymphoblastic Leukemia research、Acute Myeloid Leukemia Research、Chronic Myeloid Leukemia Treatments

PURPOSE: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) effectively treats high-risk acute lymphoblastic leukemia (ALL), yet challenges persist due to post-transplant relapse and conditioning regimen toxicities. The determination of an appropriate preconditioning regimen is critical to improving patient outcomes. In our transplant center, we have modified the traditional busulfan (Bu)/cyclophosphamide (Cy)/etoposide (Vp16) protocol by adding fludarabine (Flu) and cytarabine (Ara-C), while reducing the dosage of Cy. This novel modification seeks to enhance transplantation outcomes for ALL patients. METHODS: This study retrospectively collected clinical data from 88 high-risk ALL patients who received transplantation from June 2018 to December 2023. Among these patients, 40 received the novel modified Bu/Cy/Vp16/Flu/Ara-C conditioning protocol, while 48 received the traditional Bu/Cy/Vp16 regimen and served as a control group. RESULTS: This study demonstrated a notably reduced incidence of cardiac toxicity in patients treated with the modified Bu/Cy/Vp16/Flu/Ara-C conditioning compared to those on the traditional Bu/Cy/Vp16 regimen. Furthermore, other types of conditioning-related toxicities were within acceptable limits in the modified regimen group. Regarding efficacy, the Bu/Cy/Vp16/Flu/Ara-C protocol significantly reduced the cumulative two-year relapse rate in high-risk ALL patients compared to the Bu/Cy/Vp16 scheme (38.7% (20.9%-52.5%) vs. 11.8% (0.2%-22.1...