Reduced-intensity conditioning (RIC) has been facilitating allogeneic hematopoietic cell transplantation (allo-HCT) for patients originally considered ineligible for HCT with myeloablative conditioning. Fludarabine (Flu) with reduced doses of busulfan (Bu) (Flu + Bu) and Flu with reduced doses of melphalan (Mel) (Flu + Mel) are widely used RIC regimens for acute myeloid leukemia (AML). A nationwide retrospective study comparing clinical outcomes of adult patients with AML receiving first allo-HCT after RIC between 2001 and 2010 was performed. Cumulative incidences of relapse were not significantly different among the Flu + ivBu-based (FBiv), Flu + poBu-based (FBpo), and Flu + Mel-based (FM) groups (p = 0.29). Non-relapse mortality (NRM) was significantly lower in patients receiving FBiv compared with FBpo (p = 0.003) and FM (p < 0.001). On multivariate analysis, there was no significant difference in overall survival, but FM was associated with a significantly lower risk of relapse (hazard ratio (HR) = 0.65, 95% confidence interval (CI): 0.50–0.85, p = 0.002), higher NRM (HR = 1.60, 95% CI: 1.10–2.33, p = 0.013) and better leukemia-free survival (HR = 0.77, 95% CI: 0.63–0.95, p = 0.015) compared with FBiv. These results suggest that Flu + Mel has a more intense disease control potential and Flu + ivBu is less toxic than the other. Both RIC regimens provide similar survival outcomes and are effective and useful regimens for patients with AML who received allo-HCT.

降低强度调节 (RIC) 一直在促进异基因造血细胞移植 (allo-HCT) 用于最初被认为不适合进行清髓性调节的 HCT 的患者。减少剂量的白消安 (Bu) (Flu + Bu) 的氟达拉滨 (Flu) 和减少剂量的美法仑 (Mel) (Flu + Mel) 的流感是急性髓性白血病 (AML) 广泛使用的 RIC 方案。一项全国性回顾性研究比较了 2001 年至 2010 年间 RIC 后接受首次 allo-HCT 的成年 AML 患者的临床结果。Flu + ivBu-based (FBiv)、Flu + poBu-based (FBpo) 和 Flu + Mel-based (FM) 组的累积复发率没有显着差异 ( p  = 0.29)。与 FBpo 相比，接受 FBiv 的患者的非复发死亡率 (NRM) 显着降低。p  = 0.003) 和 FM ( p  < 0.001)。在多变量分析中，总生存期没有显着差异，但 FM 与复发风险显着降低相关（风险比 (HR) = 0.65, 95% 置信区间 (CI): 0.50–0.85, p  = 0.002），与FBiv 相比，更高的 NRM (HR = 1.60, 95% CI: 1.10–2.33, p  = 0.013) 和更好的无白血病存活率 (HR = 0.77, 95% CI: 0.63–0.95, p  = 0.015)。这些结果表明，Flu + Mel 具有更强的疾病控制潜力，Flu + ivBu 的毒性低于另一种。两种 RIC 方案都提供了相似的生存结果，并且对于接受 allo-HCT 的 AML 患者是有效且有用的方案。