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Conditioning Regimens

Retrospective analysis of treosulfan-based conditioning in comparison with standard conditioning in patients with myelodysplastic syndrome

Bone Marrow Transplantation volume 46, pages 502–509 (2011)Cite this article

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Abstract

Myelodysplastic syndromes (MDSs) often occur in older adults with significant comorbidities. Therefore, a reduced-toxicity conditioning regimen may be more suitable than standard conditioning regimens before allogeneic blood stem cell transplantation. Here, we retrospectively compare the outcome of a treosulfan-based conditioning regimen with standard myeloablative TBI-based conditioning regimens in patients (pts) with MDS. A total of 48 pts with MDS were included in the study, of which 29 (60%) pts received TBI-based and 19 (40%) pts received a treosulfan-based conditioning regimen. A significantly lower relapse incidence (5% vs 34% at 3 years, P=0.019) resulting in a better, but not statistically significant relapse-free survival (RFS) (57% vs 31%, P=0.086) was observed after treosulfan-based conditioning. In pts with increased risk for significant side effects due to comorbidities (haematopoietic stem cell transplantation specific comorbidity index), the estimated 3-year RFS was significantly better in the treosulfan group: 54% (95% confidence interval (CI), 17–90%) compared with pts in the TBI group: 11% (95% CI, 0–44%; log-rank test P=0.0455). Treosulfan-based conditioning therapy is a feasible and effective regimen for pts with MDS, especially in pts with preexisting comorbidities.

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Author notes

  1. D Wolff

    Present address: 4Current address: Department of Haematology and Oncology, University of Regensburg, Germany.,

  2. J Casper

    Present address: 5Current address: Department of Oncology and Hematology, Clinic Oldenburg, Oldenburg, Germany.,

Authors and Affiliations

  1. Department of Haematology, Oncology and Palliative Care, University of Rostock, Germany

    I Hilgendorf, D Wolff, C Junghanss, M Freund & J Casper

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

    T Gromke, R Trenschel, A H Elmaagacli & D W Beelen

  3. Department of Biometrics and Data Management, medac GmbH, Hamburg, Germany

    U Pichlmeier

Authors
  1. I Hilgendorf
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  2. D Wolff
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  3. T Gromke
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  4. R Trenschel
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  5. A H Elmaagacli
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  6. U Pichlmeier
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  8. M Freund
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  9. D W Beelen
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  10. J Casper
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Correspondence to I Hilgendorf.

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U Pichlmeier is an employee of medac GmbH.

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Hilgendorf, I., Wolff, D., Gromke, T. et al. Retrospective analysis of treosulfan-based conditioning in comparison with standard conditioning in patients with myelodysplastic syndrome. Bone Marrow Transplant 46, 502–509 (2011). https://doi.org/10.1038/bmt.2010.153

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