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Growing adoption of pharmacologic maintenance therapy after allogeneic hematopoietic cell transplantation in acute myeloid leukemia: a survey on behalf of the EBMT acute leukemia working party

Bone Marrow Transplantation volume 60, pages 921–923 (2025)Cite this article

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TO THE EDITOR:

Disease recurrence in acute myeloid leukemia (AML) is the primary cause of failure in allogeneic hematopoietic cell transplantation (allo-HCT). The risk of relapse post-transplant is influenced by several factors, including the AML genomic profile, disease status at transplant, conditioning regimen, and measurable residual disease (MRD) presence before allo-HCT [1]. To mitigate relapse risk, prophylactic pharmacologic and cellular interventions have been explored [2] to maintain remission and enhance the graft-versus-leukemia (GVL) effect without causing significant toxicity. Recent studies on hypomethylating agents (HMAs), and FLT3 inhibitors for post-allo-HCT maintenance therapy have shown promising leukemia-free survival (LFS) improvements [3,4,5,6,7,8]. Therefore, transplant physicians are increasingly adopting these interventions post-allo-HCT, supported by evidence of efficacy and tolerability [9,10,11]. However, skepticism persists due to challenges in proving efficacy through large randomized trials and concerns about long-term toxicities.

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Fig. 1: Histogram representation of questionnaire results on the use of maintenance treatment post-allogeneic transplant by EBMT centers.

Data availability

The dataset represents the results of the survey. One or multiple answers were permitted from each center depending on the question. No personal data are included. The dataset remains the property of the EBMT. The results of the survey are available upon reasonable request to the corresponding author.

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Author information

Authors and Affiliations

  1. Bone marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Iman Abou Dalle & Ali Bazarbachi

  2. Hospital Saint-Antoine, Sorbonne University; Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Paris, France

    Myriam Labopin, Eolia Brissot, Norbert-Claude Gorin & Mohamad Mohty

  3. European Society for Blood and Marrow Transplantation Statistical Unit, Hôpital Saint-Antoine, Paris, France

    Myriam Labopin

  4. European Society for Blood and Marrow Transplantation Paris Study Unit, Hôpital Saint-Antoine, Paris, France

    Irma Khvedelidze

  5. University and CHU of Liege, GIGA-I3, Liege, Belgium

    Frédéric Baron

  6. Department of Medicine 2, Hematology and Oncology, University Hospital, Goethe University Frankfurt, Frankfurt am Main, Germany

    Gesine Bug

  7. Department of Haematology, Hospital Clinic of Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain

    Jordi Esteve

  8. Department of Bone Marrow Transplantation and Oncohematology, Gliwice, Poland

    Sebastian Giebel

  9. EBMT Global Committee (Shanghai and Paris Offices) and Acute Leukemia Working Party, Hospital Saint-Antoine APHP and Sorbonne University, Paris, France

    Norbert-Claude Gorin

  10. Department of Haematology and Cell Therapy, Hospital Saint-Antoine, Sorbonne University, Paris, France

    Norbert-Claude Gorin

  11. Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Paris, France

    Norbert-Claude Gorin

  12. Hematology Unit, Romagna Transplant Network, Ravenna, University of Bologna, Bologna, Italy

    Francesco Lanza

  13. Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel

    Arnon Nagler

  14. University Hospital Center Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia

    Zina Peric

  15. Haematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Hospital, Milan, Italy

    Simona Piemontese, Annalisa Ruggeri & Fabio Ciceri

  16. University Hospital La Fe, Valencia, Spain

    Jaime Sanz

  17. Department of Haematology-Oncology, Vanderbilt University, Medical Center, Nashville, TN, USA

    Bipin Savani

  18. Department of Hematology and Oncology, Augsburg University Hospital, Augsburg, Germany

    Christoph Schmid

  19. Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Roni Shouval

  20. Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA

    Roni Shouval

  21. BMT Unit and Institute of Cell Therapy, University of Patras, Patras, Greece

    Alexandros Spyridonidis

  22. Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands

    Jurjen Versluis

Authors
  1. Iman Abou Dalle
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  2. Myriam Labopin
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  3. Irma Khvedelidze
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  9. Norbert-Claude Gorin
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  15. Jaime Sanz
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  20. Jurjen Versluis
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  21. Fabio Ciceri
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  22. Ali Bazarbachi
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  23. Mohamad Mohty
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Contributions

Contribution: I.A wrote the manuscript with input from the coauthors. I.A., M.L., I.K. contributed in survey questionnaire design, distribution, data collection and analysis. M.L. performed the statistical analysis of the data. I.A., M.M, and A.B., designed the study. All authors (M. L., I. K., F. B., E. B., G. B., J. E., S. G., N.-C. G., F. L., A. N., Z. P., S. P., A. R., J. S., B. S., C. S., R. S., A. S., J. V., F. C., A. B., and M. M.) participated in the discussion, intellectual content, and have reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Ali Bazarbachi.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was conducted in accordance with the principles of the Declaration of Helsinki. The survey obtained permission from the participating centers to answer the questions. Individual consent was not required, as no personal data were collected. No ethical board committee was needed for the approval of the survey.

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Practice Patterns of EBMT transplant centers regarding maintenance treatment post allogeneic hematopoietic cell transplantation in acute myeloid leukemia: a survey on behalf of the ALWP of the EBMT

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Abou Dalle, I., Labopin, M., Khvedelidze, I. et al. Growing adoption of pharmacologic maintenance therapy after allogeneic hematopoietic cell transplantation in acute myeloid leukemia: a survey on behalf of the EBMT acute leukemia working party. Bone Marrow Transplant 60, 921–923 (2025). https://doi.org/10.1038/s41409-025-02576-4

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