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toxicity than Bu used in a similar combination with none developing veno-occlusive disease (VOD) of the liver (including one with 6-thioguanine associated VOD 4 weeks prior to transplantation) combined with a low incidence of mucositis. Myeloablative conditioning regimes containing Bu are usually associated with a relatively high incidence of both mucositis and VOD.Reports of Treosulphan use in paediatric allografts are either in abstract form or have limited patient numbers so detailed information on outcome and toxicity is difficult to ascertain.The data available appears to confirm our experience regarding both engraftment and its favourable toxicity profile (Wachowiack et al, 2005). We are reassured that it provides sufficient anti-neoplastic activity in infant ALL (three of four in longterm CR), but possibly not in older children with very high risk ALL (three relapses in seven patients) and we have increased the total dose to 42 g/m 2 to attempt to reduce this relapse risk.In summary, Treosulphan-based myeloablative conditioning provides a high rate of primary engraftment and favourable acute toxicity profile in children undergoing allogeneic transplants for malignant and non-malignant disorders using sibling and unrelated donors with varying degrees of HLA compatibility.