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Baronciani D.,Unita Operativa Ematologia E Centro Trapianti Ospedale Oncologico Of Riferimento Regionale Armando Businco Cagliari Italy | Depau C.,Unita Operativa Ematologia E Centro Trapianti Ospedale Oncologico Of Riferimento Regionale Armando Businco Cagliari Italy | Targhetta C.,Unita Operativa Ematologia E Centro Trapianti Ospedale Oncologico Of Riferimento Regionale Armando Businco Cagliari Italy | Derudas D.,Unita Operativa Ematologia E Centro Trapianti Ospedale Oncologico Of Riferimento Regionale Armando Businco Cagliari Italy | And 5 more authors.
Hematological Oncology | Year: 2015

In recent years, with the aim of reducing transplant-related mortality, new conditioning regimens have been explored in patients not eligible for conventional haemopoietic stem cell transplantation. In this setting, we investigated safety and feasibility of the treosulfan-fludarabine-thiotepa combination prior to allogeneic haemopoietic stem cell transplantation in patients with advanced lympho-proliferative diseases and at high transplant risk. Twenty-seven consecutive patients, median age 43years (range 19-60), entered this study. All of them were affected by lympho-proliferative disease in advanced phase and have been heavily pre-treated. The median haemopoietic stem cell transplant co-morbidity index was 1 (range 0-3). Twenty-five patients had regular engraftment, while the remaining two patients were not evaluable for early deaths. Non-haematological toxicity was limited. No patient developed veno-occlusive disease. The estimated probability of overall survival and progression-free survival with a median follow-up of 40months was 52% (95% confidence interval 33-73) and 50% (95% confidence interval 30-70) respectively. Six patients have relapsed; all of them were not in remission before transplantation. The treosulfan-fludarabine-thiotepa combination is a reduced toxicity but myeloablative regimen that can be proposed to patients not fitting criteria for conventional myeloablative transplant regimens. Longer follow-up and prospective randomized studies are necessary to evaluate this regimen. © 2015 John Wiley & Sons, Ltd. Source

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