title: Phase II prospective study of treosulfan-based reduced-intensity conditioning in allogeneic HSCT for hematological malignancies from 10/10 HLA-identical unrelated donor.
abstract: Different RIC regimens were evaluated prior to allo-HSCT in different hematological malignancies. We conducted this prospective study in adult patients with various hematological malignancies in order to evaluate the toxicity and efficacy of treosulfan-based conditioning, followed by allo-HSCT from 10/10 HLA-identical unrelated donors. Conditioning included treosulfan 12 g/m(2)/day i.v. (day -6 to day -4), fludarabine 30 mg/m(2)/day i.v. (day -6 to day -2), and ATG 2.5 mg/kg/day (day -2 to day -1). PBSC were used as HSC source. We included 56 patients (29 AML, 9 MM, 8 MDS, 6 CLL, 3 ALL, and 1 CML) with a median age of 57 years (18-65.5). Fifty-four (96%) patients engrafted; the cumulative incidence of aGVHD grade ≥II at 3 months reached 31%. The cumulative incidence of cGVHD at 18 months was 34% limited and 8% extensive. The median overall survival (OS) was not reached with a 3-year probability of 52%. The cumulative incidence of relapse at 3 years was 25%, and the cumulative incidence of transplant-related mortality (TRM) at 12 and 24 months was 20% and 23%, respectively. Treosulfan appears to be a good alternative for conditioning of MUD transplant patients with promising results in terms of OS, relapse, and TRM.
authors.affiliation: Hematology, Blood and Marrow Transplant Unit, Centre Hospitalier Lyon Sud, CHU et Université de Lyon, Lyon, France. mauricette.michallet@chu-lyon.fr
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.forename: Mohamad
authors.initials: M
authors.lastname: Sobh
authors.forename: Noel
authors.initials: N
authors.lastname: Milpied
authors.forename: Jacques-Olivier
authors.initials: JO
authors.lastname: Bay
authors.forename: Sabine
authors.initials: S
authors.lastname: Fürst
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.forename: Franck E
authors.initials: FE
authors.lastname: Nicolini
authors.forename: Hélène
authors.initials: H
authors.lastname: Labussière
authors.forename: Nathalie
authors.initials: N
authors.lastname: Tedone
authors.forename: Stéphane
authors.initials: S
authors.lastname: Morisset
authors.forename: Stéphane
authors.initials: S
authors.lastname: Vigouroux
authors.forename: Joachim
authors.initials: J
authors.lastname: Baumgart
authors.forename: Reza
authors.initials: R
authors.lastname: Tabrizi
authors.forename: Didier
authors.initials: D
authors.lastname: Blaise
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002066:Busulfan / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006648:Histocompatibility / Q000187:drug effects / Q000502:physiology; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D061349:Unrelated Donors; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D006680:HLA Antigens; C018404:treosulfan; D002066:Busulfan