Treosulfan Based Conditioning Regime for Allogenic HSCT in Resource Poor Setting

Dikshit, Nidhi; Gupta, Pronati; Sengupta, Kasturi; Chakrabartty, Joydeep

doi:10.1016/j.bbmt.2018.12.790

Cited by 2 publications

(4 citation statements)

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“…This is also the main limitation of the present meta-analysis, and the interpretation of the results should be made with caution. Conventional MAC containing busulfan are among the most widely used for MDS and AML, but they have shortcomings such as toxicity and transplantation-related mortality (8)(9)(10). Treosulfan-based regimens are considered as effective as conventional MAC, but with lower toxicity and transplantrelated mortality (8,9).…”

Section: Discussionmentioning

confidence: 99%

“…Conditioning regimens play important roles in the success of allo-HSCT, and the choice of a regiment depends upon age, disease risk, ECOG status, and remission status at the time of transplantation (8,9). Conventional myeloablative conditioning regimens (MAC) containing busulfan are among the most widely used for MDS and AML, but they have shortcomings such as toxicity, veno-occlusive diseases, and mortality (8)(9)(10). Treosulfan is a recent myelotoxic and immunosuppressive prodrug that does not require enzymatic activation (11,12).…”

Section: Ntroductionmentioning

confidence: 99%

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Long-Term Outcomes of Treosulfan- vs. Busulfan-Based Conditioning Regimen for Patients With Myelodysplastic Syndrome and Acute Myeloid Leukemia Before Hematopoietic Cell Transplantation: A Systematic Review and Meta-Analysis

Zhu

Liu

et al. 2020

Front. Oncol.

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BackgroundMany studies aimed to evaluate the efficacy and safety of treosulfan-based conditioning regimens for allogeneic hematopoietic cell transplantation (allo-HCT) compared with other regimens, but different outcomes were reported across studies.AimTo determine the long-term survival outcomes of treosulfan-based vs. busulfan-based conditioning regimens in myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) patients.MethodsPubMed, Embase, and Cochrane library were searched for studies published prior to December 6, 2019. The fixed-effects model was applied for overall survival (OS), leukemia-free survival (LFS), non-relapse mortality (NRM), acute and chronic graft versus host disease (GvHD). Relapse incidence (RI) was pooled by the use of the random-effects model.ResultsSix studies were included (3,982 patients; range, 57–1,956). The pooled HR for OS favored treosulfan (HR=0.80, 95%CI: 0.71–0.90). There was no significant difference in NRM between the two regimens (HR=0.84, 95%CI=0.71–1.01). There was no significant difference in LFS between the two regimens (HR=0.98, 95%CI=0.87–1.12). Treosulfan-based regimens showed a lower risk of aGvHD (HR=0.70, 95%CI=0.59–0.82), but there was no difference for cGvHD (HR=0.94, 95%CI=0.81–1.09). There was no significant difference in RI between the two regimens (HR=0.96, 95%CI=0.71–1.31). There was no publication bias among these studies.ConclusionThe current meta-analysis determined that treosulfan-based conditioning regimens could improve the OS in patients with MDS and AML, with lower acute graft-versus-host disease incidence, compared with busulfan-based regimens.

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