International Journal of Hematology

, Volume 106, Issue 4, pp 471–475 | Cite as

Toxicological effects of fludarabine and treosulfan conditioning before allogeneic stem-cell transplantation

  • Mats Remberger
  • Johan Törlen
  • Ibrahim El Serafi
  • Karin Garming-Legert
  • Andreas Björklund
  • Per Ljungman
  • Mikael Sundin
  • Moustapha Hassan
  • Jonas Mattsson
Rapid Communication

Abstract

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.

Keywords

HSCT Treosulfan Toxicity Conditioning 

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Copyright information

© The Japanese Society of Hematology 2017

Authors and Affiliations

  • Mats Remberger
    • 1
    • 2
  • Johan Törlen
    • 1
    • 2
  • Ibrahim El Serafi
    • 8
  • Karin Garming-Legert
    • 7
  • Andreas Björklund
    • 3
    • 4
  • Per Ljungman
    • 1
    • 3
    • 4
  • Mikael Sundin
    • 5
    • 6
  • Moustapha Hassan
    • 8
  • Jonas Mattsson
    • 1
    • 2
  1. 1.Center for Allogeneic Stem Cell Transplantation UnitKarolinska University HospitalStockholmSweden
  2. 2.Department of Oncology and PathologyKarolinska InstitutetStockholmSweden
  3. 3.Department of HematologyKarolinska University HospitalStockholmSweden
  4. 4.Division of Hematology, Department of Medicine HuddingeKarolinska InstitutetStockholmSweden
  5. 5.Blood Disorders, Immunodeficiency and Stem Cell TransplantationAstrid Lindgren Children’s Hospital, Karolinska University HospitalStockholmSweden
  6. 6.Division of Pediatrics, Department of Clinical Science, Intervention and TechnologyKarolinska InstitutetStockholmSweden
  7. 7.Division of Oral and Maxillofacial Surgery, Department of Dental MedicineKarolinska InstituteStockholmSweden
  8. 8.Experimental Cancer Medicine, Department of Laboratory MedicineKarolinska InstitutetStockholmSweden

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