Comparison of Different Conditioning Regimens in Allogeneic Hematopoietic Stem-Cell Transplantation Shows Superiority of Total Body Irradiation-Based Regimen for Younger Patients With Acute Leukemia: A Nationwide Study.

Background: The optimal the conditioning regimens for allogeneic hematopoietic stem-cell transplantation, especially for East Asian patients, remains unknown. Patients and

Methods: We collected and analyzed clinical and survival data of 4255 patients from the Korean National Health Insurance Claims Database.

Results: Between 1562 myeloablative conditioning and 2693 nonmyeloablative conditioning groups, the overall survival was not statistically different. However, in the myeloablative conditioning group, the overall survival of the total body irradiation-based regimen was better than that of chemotherapy-alone regimen (P = .005). In subgroup analysis, the superiority of the total body irradiation-based regimen was especially prominent in acute leukemia (P = .012 for acute myeloid leukemia; P = .005 for acute lymphoblastic leukemia) and for younger patients (< 50 years old vs. ≥ 50 years old, P = .015).

Conclusion: Total body irradiation combination might be the best conditioning regimen for young patients undergoing hematopoietic stem-cell transplantation for acute leukemias in Korea.