最佳减弱强度预处理（RIC）方案仍存在争议。我们回顾性比较了754例40岁以上、处于第一次完全缓解期（CR）的AML患者，在进行同种异体造血干细胞移植（HSCT）时，采用氟达拉滨加8Gy分段全身放射疗法（FluTBI）和氟达拉滨加30、36或42g/m2的曲磺汀（FluTreo）预处理方案。通过对每组115名患者的倾向性得分匹配，以平衡患者特征，发现与FluTreo相比，FluTBI与重复发作的概率显著降低（18.3% vs. 34.7%，P = 0.018），但这被更高的非复发性死亡率(NRM)所抵消（16.8% vs. 5.3%，p = 0.02）。因此，两组的总生存率和移植物抗宿主病无复发生存率在2年时相似（OS分别为66.9%和67.8%，GRFS分别为50.3%和45.6%）。年龄分组的单变量分析表明，在FluTBI组中，仅年龄≥55岁的患者中NRM更高（27.6% vs. 5.8%，p = 0.02），而在两组中<55岁的患者中，NRM非常低（分别为6.0% vs. 4.7%，P = ns）。我们得出结论：这两种预处理方案均是有效且安全的，但FluTBI可能更适用于55岁以下的年轻患者。 ©2023. 作者。

The optimal reduced intensity conditioning (RIC) regimen is a matter of debate. We retrospectively compared conditioning with fludarabine plus fractionated total body irradiation of 8 Gy (FluTBI) and fludarabine plus treosulfan 30, 36 or 42 g/m2 (FluTreo) in 754 patients with AML above the age of 40 years undergoing an allogeneic hematopoietic stem cell transplant (HSCT) in first complete remission (CR). After balancing patient characteristics by propensity score matching of 115 patients in each group, FluTBI was associated with a significantly lower probability of relapse compared to FluTreo (18.3% vs. 34.7%, p = 0.018) which was counteracted by a higher non-relapse mortality (NRM, 16.8% vs. 5.3%, p = 0.02). Thus, overall survival and graft-versus-host disease-free and relapse-free survival at 2 years were similar between groups (OS 66.9% vs. 67.8%, GRFS 50.3% vs. 45.6%). Univariate analysis by age group demonstrated a higher NRM exclusively in patients ≥55 years of age treated with FluTBI compared to FluTreo (27.6% vs. 5.8%, p = 0.02), while a similarly low NRM was observed in patients <55 years in both groups (6.0% vs. 4.7%, p = ns). We conclude that both conditioning regimens are effective and safe, but FluTBI may better be reserved for younger patients below the age of 55 years.© 2023. The Author(s).