title: Retrospective analysis of treosulfan-based conditioning in comparison with standard conditioning in patients with myelodysplastic syndrome.
abstract: Myelodysplastic syndromes (MDSs) often occur in older adults with significant comorbidities. Therefore, a reduced-toxicity conditioning regimen may be more suitable than standard conditioning regimens before allogeneic blood stem cell transplantation. Here, we retrospectively compare the outcome of a treosulfan-based conditioning regimen with standard myeloablative TBI-based conditioning regimens in patients (pts) with MDS. A total of 48 pts with MDS were included in the study, of which 29 (60%) pts received TBI-based and 19 (40%) pts received a treosulfan-based conditioning regimen. A significantly lower relapse incidence (5% vs 34% at 3 years, P=0.019) resulting in a better, but not statistically significant relapse-free survival (RFS) (57% vs 31%, P=0.086) was observed after treosulfan-based conditioning. In pts with increased risk for significant side effects due to comorbidities (haematopoietic stem cell transplantation specific comorbidity index), the estimated 3-year RFS was significantly better in the treosulfan group: 54% (95% confidence interval (CI), 17-90%) compared with pts in the TBI group: 11% (95% CI, 0-44%; log-rank test P=0.0455). Treosulfan-based conditioning therapy is a feasible and effective regimen for pts with MDS, especially in pts with preexisting comorbidities.
authors.affiliation: Department of Haematology, Oncology and Palliative Care, University of Rostock, Germany. inken.hilgendorf@med.uni-rostock.de
authors.forename: I
authors.initials: I
authors.lastname: Hilgendorf
authors.forename: D
authors.initials: D
authors.lastname: Wolff
authors.forename: T
authors.initials: T
authors.lastname: Gromke
authors.forename: R
authors.initials: R
authors.lastname: Trenschel
authors.forename: A H
authors.initials: AH
authors.lastname: Elmaagacli
authors.forename: U
authors.initials: U
authors.lastname: Pichlmeier
authors.forename: C
authors.initials: C
authors.lastname: Junghanss
authors.forename: M
authors.initials: M
authors.lastname: Freund
authors.forename: D W
authors.initials: DW
authors.lastname: Beelen
authors.forename: J
authors.initials: J
authors.lastname: Casper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002066:Busulfan / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015897:Comorbidity; D018572:Disease-Free Survival; D006801:Humans; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D014916:Whole-Body Irradiation; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; C018404:treosulfan; D002066:Busulfan