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Acute Leukemia

Allogeneic stem cell transplantation after conditioning with treosulfan, etoposide and cyclophosphamide for patients with ALL: a phase II-study on behalf of the German Cooperative Transplant Study Group and ALL Study Group (GMALL)

Bone Marrow Transplantation volume 50, pages 1503–1507 (2015)Cite this article

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Abstract

TBI-based preparative regimens are considered as standard conditioning therapy for allogeneic stem cell transplantation (AHSC) in patients with ALL. We investigated toxicity and efficacy of a non-TBI-based regimen consisting of treosulfan, etoposide and cyclophosphamide for ALL within a prospective study. Major inclusion criteria were CR and non-eligibility for TBI. Fifty patients with a median age of 46.5 years (range, 18–64) were included. Donors were HLA-identical sibling (n=8), matched (n=42) or mismatched (n=10) unrelated. The toxicity was moderate, resulting in a cumulative incidence of non-relapse mortality (NRM) at 1 year of 8% (90% confidence interval: 2–15%). Acute GvHD grade II–IV and grade III/IV was noted in 53% and 14%, respectively. Chronic GvHD at one year was seen in 41%. After a median follow-up of 24 months the cumulative incidence of relapse was 36% (90% confidence interval: 24–48) and 51% (90% confidence interval: 37–65) at 1 and 2 years, respectively. The estimated 2-year disease-free and overall survivals were 36 and 48%, respectively. Treosulfan, etoposide and cyclophosphamide followed by AHSC has a favorable toxicity profile with low NRM and therefore represents a potential alternative regimen for ALL in 1. CR (NCT00682305).

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Author information

Authors and Affiliations

  1. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    N Kröger, M Heinzelmann, C Wolschke, F Ayuk & A Zander

  2. Department of Hematology/Oncology, University Hospital Dresden, Dresen, Germany

    M Bornhäuser

  3. Department of Hematology/Oncology, University Hospital Münster, Münster, Germany

    M Stelljes

  4. CTS—Clinical Trial Solutions, Wedel, Germany

    U Pichlmeier

  5. Department of Bone Marrow Transplantation, University Hospital, Essen, Germany

    R Trenschel & D Beelen

  6. Department of Hematology/Oncology, Community Hospital, Augsburg, Germany

    C Schmid

  7. Department of Hematology/Oncology, University Hospital Charité, Berlin, Germany

    R Arnold

  8. Department of Hematology/Oncology, University Hospital, Frankfurt, Germany

    H Martin

  9. Department of Hematology/Oncology, University Medical Center Mainz, Mainz, Germany

    R G Meyer

  10. Department of Hematology/Oncology, University Hospital, Tübingen, Germany

    W Bethge

  11. Department of Hematology/Oncology, University Hospital, Düsseldorf, Germany

    G Kobbe

  12. Study Office German ALL Study Group (GMALL), Frankfurt, Germany

    N Gökbuget & D Hölzer

Authors
  1. N Kröger
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  2. M Bornhäuser
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  11. R G Meyer
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  14. F Ayuk
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  15. N Gökbuget
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Corresponding author

Correspondence to N Kröger.

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Competing interests

NK received research funding from Medac/Germany. The remaining authors declare no conflict of interest.

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Author contributions

NK designed the study, interpreted the data and wrote the manuscript. UP assisted in the study design, analyzed the data, performed statistics and edited the manuscript. MB, MS, RT, CS, RA, HM, MH, CW, RGM, WB, GK, FA, NG, DH, AZ and DB assisted with data collection and edited the manuscript.

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Kröger, N., Bornhäuser, M., Stelljes, M. et al. Allogeneic stem cell transplantation after conditioning with treosulfan, etoposide and cyclophosphamide for patients with ALL: a phase II-study on behalf of the German Cooperative Transplant Study Group and ALL Study Group (GMALL). Bone Marrow Transplant 50, 1503–1507 (2015). https://doi.org/10.1038/bmt.2015.202

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