Precision radiation may boost transplant success in tough leukemia cases

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Underlying diagnosis of acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS), A) Acute Myeloid Leukemia (AML), meeting at least one of the following criteria: i. Relapsed disease after a prior complete remission (CR) or ii. Disease refractory to at least two cycles of intensive chemotherapy or iii. High-risk AML in complete remission (CR), defined by at least one of the following: iii a) Adverse molecular or cytogenetic risk according to ELN 2022 classification or iii b) Presence of measurable/minimal residual disease (MRD). B) Myelodysplastic Syndrome (MDS), meeting at least one of the following criteria: i. Relapsed MDS with increased blasts (MDS-IB) or ii. MDS-IB2 without reduction of bone marrow blasts below 10% after induction chemotherapy or after at least two cycles of azacitidine or iii. IPSS-M score \> 0.5 (high-risk or very high-risk disease). 2. Eligibility confirmed by the institutionalal Transplant Indication Committee according to standard criteria. 3. Age ≥ 18 years and ≤ 65 years 4. Ability to understand and voluntarily sign written informed consent Exclusion Criteria: Severe comorbidity, defined as the presence of one or more of the following conditions: 1. Left ventricular ejection fraction (LVEF) \< 40% 2. Creatinine clearance \< 0.5 mL/s 3. Total bilirubin \> 40 µmol/L (unless attributable to Gilbert's syndrome or hemolysis) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) \> 5 × upper limit of normal (ULN) 4. Pulmonary function impairment defined as forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) \< 50% of predicted value, or diffusing capacity of the lung for carbon monoxide (DLCO) \< 50% of predicted value after correction for anemia 5. Karnofsky Performance Status \< 70% 6. Active viral hepatitis or human immunodeficiency virus (HIV) infection 7. Presence of liver cirrhosis 8. Pregnancy