2020
DOI: 10.3390/cancers12113098
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Treosulfan-Based Conditioning Regimen for Second Allograft in Patients with Myelofibrosis

Abstract: Relapse after allogeneic hematopoietic stem cell transplantation (AHSCT) in myelofibrosis (MF) patients remains as a significant issue despite advances in transplantation procedures and significant prolongation in survival. Second AHSCT is a potential treatment option but associated with high treatment-related mortality and novel less toxic conditioning regimens are needed. In 33 MF patients with relapse after AHSCT and failure to donor lymphocyte infusion (DLI) we investigated treosulfan (36–42 g/m2) in combi… Show more

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Cited by 11 publications
(9 citation statements)
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“…Data in the literature concerning the role of a second allo-HCT for MF remains sparse, although there have been some comprehensive recent publications (43,48,49). Most patients are not suitable so patient selection is paramount.…”
Section: Role Of Second Allo-hct For Relapse or Graft Failurementioning
confidence: 99%
See 1 more Smart Citation
“…Data in the literature concerning the role of a second allo-HCT for MF remains sparse, although there have been some comprehensive recent publications (43,48,49). Most patients are not suitable so patient selection is paramount.…”
Section: Role Of Second Allo-hct For Relapse or Graft Failurementioning
confidence: 99%
“…The optimal conditioning regimen for a second transplant remains unclear; however, it should ideally be of low toxicity and exert a strong 'anti-MF' effect. The Hamburg group reported a single centre experience (n=33) of second allo-HCT for MF using treosulphan (36-42g/m2)-based conditioning in combination with fludarabine and ATG (49). Timely engraftment occurred in all but one patient and the rates of full donor chimerism were satisfactory.…”
Section: Role Of Second Allo-hct For Relapse or Graft Failurementioning
confidence: 99%
“…Each patient received treosulfan dosed at 36-42 mg/m 2 in combination with fludarabine and ATG for a second HSCT. 68 All patients in this cohort achieved successful leukocyte engraftment by a median of day 11 and approximately 56% experienced acute grade II-IV GVHD at day 100. Overall, patients experienced a decent toxicity profile, disease-free and OS at five years.…”
Section: Relapse Post-allogeneic Hsctmentioning
confidence: 89%
“…A more recent study, however, specifically focused on the use of a treosulfan‐based conditioning regimen in 33 patients with MF with relapse after HSCT and failure of DLI. Each patient received treosulfan dosed at 36–42 mg/m 2 in combination with fludarabine and ATG for a second HSCT 68 . All patients in this cohort achieved successful leukocyte engraftment by a median of day 11 and approximately 56% experienced acute grade II–IV GVHD at day 100.…”
Section: Relapse Post‐allogeneic Hsctmentioning
confidence: 99%
“…In a study of patients who relapsed following transplant, and were DLI refractory, a second allograft with treosulfan-based conditioning was performed, with a 3-year OS of 59%, RR of 16%, and NRM of 31%. 104 These positive outcomes are unique to second transplant for MF, with incrementally poorer outcomes observed following second allograft for other hematological malignancies. 105 We recommend use of DLI or second allograft in patients with mixed or declining chimerism.…”
Section: Second Allograftmentioning
confidence: 99%