Total Marrow/Lymphoid Irradiation in the Conditioning Regimen for Haploidentical T-Cell-Depleted Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia: The Perugia Experience

This chapter briefly outlines Perugia University’s experience with haploidentical hematopoietic stem cell transplantation (HSCT) for acute myeloid leukemia (AML). It describes modifications to the conditioning regimens over time, focusing on the contribution from radiation oncology and the changes to the haploidentical graft. It reports outcomes in a subset of elderly or unfit young patients with AML who received an immunosuppressive, myeloablative, low-toxic total marrow/lymphoid irradiation (TMLI)-based conditioning regimen and a CD34+ inoculum with Treg/Tcon adoptive immunotherapy. Finally, perspectives and future directions of TMLI are illustrated.