Treosulfan, Fludarabine and Cytarabine as a Conditioning Regimen for Allogeneic Haematopoietic Stem Cell Transplantation in Patients with Acute Myeloid Leukaemia, Myelodysplastic Syndrome and Myeloproliferative Neoplasms
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Media type:
Electronic Thesis;
E-Book
Title:
Treosulfan, Fludarabine and Cytarabine as a Conditioning Regimen for Allogeneic Haematopoietic Stem Cell Transplantation in Patients with Acute Myeloid Leukaemia, Myelodysplastic Syndrome and Myeloproliferative Neoplasms
Contributor:
Henderson, Samantha
[Author]
Published:
Carl von Ossietzky Universität Oldenburg: /oops/ - Oldenburger Online-Publikations-Server, 2020
Footnote:
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Description:
Treosulfan and fludarabine (Treo/Flu) were successfully introduced into toxicity-reduced conditioning for stem cell transplantations (SCT). The risk of relapse remains a concern. We report the results of an individual treatment approach with Treo/Flu and cytarabine (Treo/Flu/AraC) prior to allogeneic SCT in patients with acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS) or a myeloproliferative neoplasm (MPN). 77 patients (median age 54 years) with high-risk disease were included. Median follow-up was 3.2 years. One-, two- and three-year RFS were 47.5%, 40.7% and 37.3% and OS were 59.3%, 49.3% and 45.4%, respectively. Cumulative incidence (CI) of NRM was 10% at 100 days, 18.8% at one year and 20.1% at two years. The CI of relapse increased from 34% at one year to 41% after three years. The CIs of engraftment, chimerism, GvHD and toxicities were acceptable and comparable with similar patients conditioned with Treo/Flu or FLAMSA-RIC. Treo/Flu/AraC provides tolerable and feasible conditioning for patients with AML, MDS or MPN at high risk of relapse. A prospective controlled trial is needed to make conclusions as to the effectiveness of this regimen.