Toxicological effects of fludarabine and treosulfan conditioning before allogeneic stem-cell transplantation
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We studied early potential treosulfan-related toxicity in 118 patients treated with treosulfan-based conditioning before allogeneic hematopoietic stem-cell transplantation. Most patients (n = 93) had a hematological malignancy. In 80 cases, a HLA-A, -B and -DR matched unrelated donor was used, while 33 patients had a HLA-identical sibling donor, and five received an HLA-A, -B or -DR allele mismatched, unrelated donor. Levels of AST, ALT, and bilirubin were significantly increased 1 week after HSCT compared to before HSCT. However, only a few patients had transaminase levels >2 to 3 × the upper normal level. All patients became neutropenic; 61% were already so at the time of graft infusion. Nearly all patients engrafted, except for three who died very early. Non-relapse mortality was 7.5% at 100 days and 11.9% at 1 year after HSCT. Veno-occlusive disease of the liver occurred in one patient and hemorrhagic cystitis in two patients. This study shows that early regimen-related toxicity after HSCT was low despite similar marrow toxicities compared to myeloablative regimens.
KeywordsHSCT Treosulfan Toxicity Conditioning
This study was supported by Grants from the Swedish Cancer Society (CF2014-2016), the Swedish Children’s Cancer Foundation (PR2013-0022, PR2015-0113 and KF2013-0011), the Marianne and Marcus Wallenbergs Foundation (2013.0117), the Foundation Olle Engkvist Byggmästare and grants provided by the Stockholm County Council (ALF-project 20140451).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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