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Treosulfan–fludarabine–thiotepa conditioning before allogeneic haemopoietic stem cell transplantation for patients with advanced lympho‐proliferative disease. A single centre study
Author(s) -
Baronciani Donatella,
Depau Cristina,
Targhetta Clara,
Derudas Daniele,
Culurgioni Fabio,
Tandurella Igor,
Latte Giancarlo,
Palmas Angelo,
Angelucci Emanuele
Publication year - 2016
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2187
Subject(s) - thiotepa , treosulfan , medicine , fludarabine , transplantation , surgery , regimen , hematopoietic stem cell transplantation , busulfan , chemotherapy , cyclophosphamide
In recent years, with the aim of reducing transplant‐related mortality, new conditioning regimens have been explored in patients not eligible for conventional haemopoietic stem cell transplantation. In this setting, we investigated safety and feasibility of the treosulfan–fludarabine–thiotepa combination prior to allogeneic haemopoietic stem cell transplantation in patients with advanced lympho‐proliferative diseases and at high transplant risk. Twenty‐seven consecutive patients, median age 43 years (range 19–60), entered this study. All of them were affected by lympho‐proliferative disease in advanced phase and have been heavily pre‐treated. The median haemopoietic stem cell transplant co‐morbidity index was 1 (range 0–3). Twenty‐five patients had regular engraftment, while the remaining two patients were not evaluable for early deaths. Non‐haematological toxicity was limited. No patient developed veno‐occlusive disease. The estimated probability of overall survival and progression‐free survival with a median follow‐up of 40 months was 52% (95% confidence interval 33–73) and 50% (95% confidence interval 30–70) respectively. Six patients have relapsed; all of them were not in remission before transplantation. The treosulfan–fludarabine–thiotepa combination is a reduced toxicity but myeloablative regimen that can be proposed to patients not fitting criteria for conventional myeloablative transplant regimens. Longer follow‐up and prospective randomized studies are necessary to evaluate this regimen. Copyright © 2015 John Wiley & Sons, Ltd.