Treosulfan-Based Conditioning Regimen for Second Allograft in Patients with Myelofibrosis
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Treosulfan-Based Conditioning Regimen for Second Allograft in Patients with Myelofibrosis. / Atagunduz, Isik Kaygusuz; Klyuchnikov, Evgeny; Wolschke, Christine; Janson, Dietlinde; Heidenreich, Silke; Christopeit, Maximilian; Ayuk, Francis; Kröger, Nicolaus.
In: CANCERS, Vol. 12, No. 11, 23.10.2020.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Treosulfan-Based Conditioning Regimen for Second Allograft in Patients with Myelofibrosis
AU - Atagunduz, Isik Kaygusuz
AU - Klyuchnikov, Evgeny
AU - Wolschke, Christine
AU - Janson, Dietlinde
AU - Heidenreich, Silke
AU - Christopeit, Maximilian
AU - Ayuk, Francis
AU - Kröger, Nicolaus
N1 - Prof. Isik Kaygusuz Atagunduz hat den Artikel im Rahmen ihres einjährigen Gastarztaufenthaltes in der Klinik für Stammzelltransplantation publiziert. Wir bitten um Statusänderung auf intern. Danke
PY - 2020/10/23
Y1 - 2020/10/23
N2 - Relapse after allogeneic hematopoietic stem cell transplantation (AHSCT) in myelofibrosis (MF) patients remains as a significant issue despite advances in transplantation procedures and significant prolongation in survival. Second AHSCT is a potential treatment option but associated with high treatment-related mortality and novel less toxic conditioning regimens are needed. In 33 MF patients with relapse after AHSCT and failure to donor lymphocyte infusion (DLI) we investigated treosulfan (36-42 g/m2) in combination with fludarabine and anti-thymocyte globulin (ATG) as conditioning regimen for a second AHSCT with matched related (n = 2), unrelated (n = 23), or mismatched unrelated (n = 8) donors. All patients achieved leukocyte engraftment after a median of 11 days, and 56 ± 13% experienced acute GVHD grade II-IV at day 100. The therapy-related mortality at day 100 and at 3 years was 16% and 31%, respectively. The cumulative incidence of relapse at 5 years was 16%, resulting in a 5-year disease-free and overall survival of 45% and 47%, respectively. Treosulfan-based conditioning for second allograft in relapsed MF patients resulted in about 50% of the patients in long-term freedom from disease.
AB - Relapse after allogeneic hematopoietic stem cell transplantation (AHSCT) in myelofibrosis (MF) patients remains as a significant issue despite advances in transplantation procedures and significant prolongation in survival. Second AHSCT is a potential treatment option but associated with high treatment-related mortality and novel less toxic conditioning regimens are needed. In 33 MF patients with relapse after AHSCT and failure to donor lymphocyte infusion (DLI) we investigated treosulfan (36-42 g/m2) in combination with fludarabine and anti-thymocyte globulin (ATG) as conditioning regimen for a second AHSCT with matched related (n = 2), unrelated (n = 23), or mismatched unrelated (n = 8) donors. All patients achieved leukocyte engraftment after a median of 11 days, and 56 ± 13% experienced acute GVHD grade II-IV at day 100. The therapy-related mortality at day 100 and at 3 years was 16% and 31%, respectively. The cumulative incidence of relapse at 5 years was 16%, resulting in a 5-year disease-free and overall survival of 45% and 47%, respectively. Treosulfan-based conditioning for second allograft in relapsed MF patients resulted in about 50% of the patients in long-term freedom from disease.
U2 - 10.3390/cancers12113098
DO - 10.3390/cancers12113098
M3 - SCORING: Journal article
C2 - 33114179
VL - 12
JO - CANCERS
JF - CANCERS
SN - 2072-6694
IS - 11
ER -