Comparison of a New Reduced Toxicity Myeloablative Treosulfan and Fludarabine Preparative Regimen with Myeloablative Busulfan or Melphalan in Combination with Fludarabine in Older Patients with Acute Myeloid Leukemia or Myelodysplastic Syndromes: A Retrospective Matched Pair Analysis of Patients from a Prospective Randomized Trial and the European Blood and Marrow Transplantation Society Registry

Background The best preparative regimen for the growing number of older acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) patients undergoing allogeneic hematopoietic cell transplantation (HCT) from matched related (MRD) or unrelated donors (MUD) remains undefined. A large randomized phase III trial (MC-FludT.14/L study: ClinicalTrials.gov Identifier: NCT00822393) recently demonstrated that myeloablative intravenous (IV) treosulfan (10 g/m² IV on days -4 to -2) in combination with fludarabine (TreoFlu) improves outcome in older and/or comorbid patients with AML in complete remission (CR) or MDS compared with the reference reduced intensity busulfan (0.8 mg/kg IV in 6-hour inte…