title: Reduced-intensity conditioning regimen with thiotepa and fludarabine followed by allogeneic blood stem cell transplantation in haematological malignancies.
abstract: The aim of this study was to investigate thiotepa (TT) and fludarabine (Fluda) as a preparative regimen for allogeneic peripheral stem cell transplant in patients not eligible for a standard myeloablative regimen due to comorbidities and/or poor performance status. TT was given at a dose of 10 mg/kg over 2 days and Fluda at 125 mg/m(2) over 5 days. In all, 21 patients (14 male, seven female; 10 acute leukaemia, eight myelodysplastic syndrome, two non-Hodgkin's lymphoma, one Hodgkin's disease) were treated. The median age was 51 years (range 30-55 years). All patients achieved full donor-type chimaerism. Adverse events included mild nausea and vomiting in two patients and a slight increase of serum amylase in three. A total of 13 patients received RBC transfusions (median 6 U, range 1-23), and all received platelets (median 4 U, range 1-27). Four patients died of nonrelapse causes and five of relapse. The 1-year probabilities of transplant-related mortality and relapse were 19 and 29%, respectively. In total, 12 patients remain in complete remission (median follow-up: 786 days). The 3-year overall survival probability was 58%. We conclude that this regimen is feasible and well tolerated.
authors.affiliation: Bone Marrow Transplantation Unit, Division of Haematology, IRCCS Policlinico San Matteo, Viale Golgi N. 19, Pavia 27100, Italy. alessandrino@smatteo.pv.it
authors.forename: E P
authors.initials: EP
authors.lastname: Alessandrino
authors.forename: P
authors.initials: P
authors.lastname: Bernasconi
authors.forename: A A
authors.initials: AA
authors.lastname: Colombo
authors.forename: D
authors.initials: D
authors.lastname: Caldera
authors.forename: L
authors.initials: L
authors.lastname: Malcovati
authors.forename: D
authors.initials: D
authors.lastname: Troletti
authors.forename: L
authors.initials: L
authors.lastname: Vanelli
authors.forename: M
authors.initials: M
authors.lastname: Varettoni
authors.forename: F
authors.initials: F
authors.lastname: Montanari
authors.forename: M
authors.initials: M
authors.lastname: Lazzarino
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000633:toxicity; D001803:Blood Transfusion; D005260:Female; D006085:Graft Survival; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D012008:Recurrence; D012074:Remission Induction; D016019:Survival Analysis; D013852:Thiotepa / Q000008:administration & dosage* / Q000633:toxicity; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000633:toxicity
chemical_list: D013852:Thiotepa; D014740:Vidarabine; C024352:fludarabine