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December 8, 2025BloodOpen Access

Efficacy and safety of FLAG and CLAG regimens (Replacing Cyclophosphamide) in conditioning for allogeneic hematopoietic stem cell transplantation in relapsed/refractory malignant hematologic diseases

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Authors

YSYanzhi SongQWQi Wang

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Overview

Trial shows FLAG and CLAG regimens improve outcomes in malignant hematologic diseases, suggesting effective alternatives to cyclophosphamide for conditioning.

Key Points

  • Patients achieved durable engraftment with a 2-year leukemia-free survival rate of 47.3% and overall survival rate of 62.5%.
  • The FLAG group had slightly higher survival rates but no statistical significance compared to the CLAG group.
  • Total body irradiation and busulfan were used in conditioning with G-CSF, fludarabine, and cladribine.
  • Graft-versus-host disease prophylaxis was managed with cyclosporine and methotrexate with no significant post-transplant infection differences.

Cite This Study

Song et al. (2025) studied this question.

synapsesocial.com/papers/69362f5a4fa91c937236dbb0https://doi.org/10.1182/blood-2025-5993
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Salvage allogeneic hematopoietic stem cell transplantation conditioning regimens for relapsed/refractory acute leukemia: Efficacy of radiotherapy combined with CLAG vs FLAG2025
  2. 2Allogeneic hematopoietic stem cell transplantation for hematological malignancies using nonmyeloablative fludarabine, cyclophosphamide, 200 centigray total body irradiation, and post-transplant cyclophosphamide, sirolimus, and mycophenolate mofetil for graft-versus-host disease prophylaxis is associated with low non-relapse mortality.2025
  3. 3An evolving landscape – how changing conditioning regimes can improve myelofibrosis transplant outcomes.2025
  4. 4Therapy related core binding factor Acute Myeloid Leukemia (CBF-AML) responds favorably to fludarabine, cytarabine, GCSF (FLAG) based therapy: Exploratory Analysis from a Phase 2 trial2025
  5. 5Superior long-term outcomes with fludarabine and melphalan reduced intensity regimen in older AML/MDS patients undergoing allogeneic stem cell transplantation: An analysis of CIBMTR data2025