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Conditioning Regimens

A fludarabine, thiotepa reduced toxicity conditioning regimen designed specifically for allogeneic second haematopoietic cell transplantation after failure of previous autologous or allogeneic transplantation

Bone Marrow Transplantation volume 41, pages 845–850 (2008)Cite this article

Abstract

We present a phase II study of fludarabine 5 × 30 mg/m2, thiotepa 3 × 5 mg/kg as preparative regimen specifically for allogeneic second haematopoietic stem cell transplantation (HCT) after failure of previous HCT. Forty-nine patients (median age 52 years, range 27–68) received an allogeneic second HCT after failed autologous (n=29) or allogeneic (n=20) HCT. Diagnoses were AML (n=18), ALL (n=3), multiple myeloma (n=11), lymphoma (n=16) and CML (n=1). GVHD prophylaxis consisted of CYA and mainly low dose alemtuzumab (40 mg). The median follow-up for patients alive is 528 days (range 217–1344). In 43 of 49 (88%) evaluable patients response rates were CR=19, PR=14 and SD=10 at one month. At one year, the probability (95% confidence interval) of relapse is 55.1 (38.2–72)% and the nonrelapse mortality (NRM) is 29 (14.2–44.4)%. Estimated survival at one year is 42.6 (28.7–56.6)% and event free survival is 38.1 (24.4–51.8)%. Survival was significantly better for patients experiencing relapse beyond one year, than for patients relapsing within one year from first transplantation (51.2 (33.5–68.9)% vs 27 (7–48.5)%; P=0.013). We conclude that this regimen is feasible and well tolerated for allogeneic second HCT.

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Author notes

  1. A Spyridonidis

    Present address: 2Current address: Patras University Medical School, Department of International Medicine, Haematology Division, Rion/Patras 26500, Greece.,

Authors and Affiliations

  1. Department of Haematology and Oncology, Albert Ludwigs-University Medical Center Freiburg, Freiburg, Germany

    C Grüllich, H Bertz, A Spyridonidis, C I Müller & J Finke

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Correspondence to J Finke.

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Grüllich, C., Bertz, H., Spyridonidis, A. et al. A fludarabine, thiotepa reduced toxicity conditioning regimen designed specifically for allogeneic second haematopoietic cell transplantation after failure of previous autologous or allogeneic transplantation. Bone Marrow Transplant 41, 845–850 (2008). https://doi.org/10.1038/sj.bmt.1705989

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