{
  "abstract": "Background\n\nRelapsed/refractory (R/R) acute leukemia (AL) carries a poor prognosis, with allogeneic hematopoietic stem cell transplantation (allo-HSCT) the primary curative option. Total body irradiation (TBI)-based conditioning is a cornerstone, but optimizing intensity remains challenging. Thiotepa, a bifunctional alkylating agent, may enhance disease control when added to TBI, but data in R/R AL are lacking.Methods\n\nThis single-center retrospective study (2020-2025) included R/R AL and lymphoma patients receiving TBI-based conditioning with (TBI + TT) or without (TBI) thiotepa. Propensity score matching (1:2, caliper = 0.2) used 9 covariates. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Secondary endpoints included relapse, non-relapse mortality (NRM), engraftment, GVHD, CMV infection, and mucositis. Kaplan-Meier, Fine-Gray competing risk, and inverse probability of treatment weighting (IPTW) analyses were employed.Results\n\nAfter matching, 48 TBI + TT and 86 TBI patients were analyzed. OS (HR = 0.901, 95% CI 0.569-1.425, P = 0.655) and DFS (HR = 0.809, 95% CI 0.504-1.299, P = 0.380) were comparable. The 1-year relapse cumulative incidence was lower with TBI + TT (6.7% vs. 17.8%, Gray's P = 0.035; multivariable sHR = 0.280, 95% CI 0.083-0.942, P = 0.040), though hypothesis-generating given only 3 relapse events. NRM was comparable (Gray's P = 0.374). Mucositis was significantly higher with TBI + TT (81.2% vs. 64.0%, P = 0.049). IPTW confirmed comparable OS (P = 0.690) and DFS (P = 0.975).Conclusion\n\nAdding thiotepa to TBI-based conditioning for R/R AL is associated with lower relapse incidence without compromising OS, DFS, engraftment, or GVHD, at the cost of increased mucosal toxicity. The relapse finding requires cautious interpretation and prospective validation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology, Aerospace Center Hospital, Beijing, 100049, China.",
    "Department of Hematology, Aerospace Center Hospital, Beijing, 100049, China. wangjingbo@asch.net.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Minglu Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuqin Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaoyong Man"
    },
    {
      "affs": [
        0
      ],
      "name": "Hongxia Wen"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei Wei"
    },
    {
      "affs": [
        0
      ],
      "name": "Yixin Yang"
    },
    {
      "affs": [
        1
      ],
      "name": "Jingbo Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bkxkmcezwztbh.bib",
  "cited_by": 0,
  "doi": "10.1007/s00277-026-07198-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13680291",
  "id": "bkxkmcezwztbh",
  "issns": [
    "0939-5555",
    "1432-0584"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897391",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC31-1245"
    ],
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7170716526",
  "pdf_url": "https://europepmc.org/articles/PMC13680291?pdf=render",
  "pmcid": "PMC13680291",
  "pmid": "42897391",
  "published": "2026-07-01",
  "publisher": "Springer",
  "ris": "https://research.draconitic.com/paper/bkxkmcezwztbh.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42897391",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897391"
    },
    {
      "first_seen": "2026-10-30T13:45:32Z",
      "native_id": "1506ce9bf2c04d69896144c66e393c0e",
      "source": "doaj",
      "url": "https://doi.org/10.1007/s00277-026-07198-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2720|Hematopoietic Stem Cell Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Addition of thiotepa to total body irradiation-based conditioning in allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute leukemia and lymphoma: a propensity score-matched retrospective study.",
  "title_text": "Addition of thiotepa to total body irradiation-based conditioning in allogeneic hematopoietic stem cell transplantation for relapsed/refractory acute leukemia and lymphoma: a propensity score-matched retrospective study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:20:39Z",
  "url": "https://research.draconitic.com/paper/bkxkmcezwztbh",
  "venue": "Annals of hematology",
  "versions": []
}