Overview
- Fifty-one next-generation sequencing MRD–negative patients aged 1–30 received myeloablative non–total body irradiation conditioning across 45 North American centers.
- With a median follow-up of 2.3 years, the 2-year event-free survival was 76.3% and overall survival was 82.0%, comparable with historical TBI-based benchmarks.
- Most participants (86%) received busulfan, fludarabine, and thiotepa, with graft sources including bone marrow (71%), peripheral blood (21%), and cord blood (8%).
- Reported outcomes included one early transplant-related death (2%), 12% non-relapse mortality, six relapses, acute GVHD in 39%, and chronic GVHD in 25% with most requiring systemic therapy.
- Investigators said NGS-MRD–negative patients may consider TBI-free conditioning, while emphasizing the need for longer follow-up, broader validation, and refined risk stratification.