Comparison of Fludarabine/Treosulfan Conditioning with Melphalan-Based Sequential Conditioning in Patients with MDS and Increased Blasts Undergoing Upfront Transplantation

Background

Upfront allogeneic stem cell transplantation (allo-SCT) without pretransplant cytoreduction is an established concept in patients with myelodysplastic syndromes with increased blasts (MDS-IB), but the optimal conditioning strategy remains to be defined. While fludarabine and treosulfan (Flu/Treo) has become an established regimen for older patients based on its favorable ratio between toxicity and efficacy, its impact when used in the context of upfront transplant is less well described.