Incorporation of thiotepa in a reduced intensity conditioning regimen may improve engraftment after transplant for HLH

Challenges in HLH transplant: Tricks to prevent menace of mixed chimerism

“…Wustrau et al noted that treosulfan versus melphalan did not change the incidence of mixed chimerism but adding thiotepa decreased that incidence from 50 to 25%. A similar observation was made in a recently published article by Naik et al 8 . How active disease status affects patients’ survival is not widely studied.…”

Challenges in HLH transplant: Tricks to prevent menace of mixed chimerism

“…Wustrau et al noted that treosulfan versus melphalan did not change the incidence of mixed chimerism but adding thiotepa decreased that incidence from 50% to 25%. Similar observation was made in recently published article by Naik et al 8 How active disease status affects patients survival is not widely studied. As the new IFN-γ targeting therapy-Emapalumab is approved for primary HLH treatment, it is encouraging that more patients will pro-ceed to HSCT in remission.…”

EBMT/ESID inborn errors working party guidelines for hematopoietic stem cell transplantation for inborn errors of immunity

“…Thiotepa is an alkylating drug which is often combined with either treosulfan and fludarabine as a myeloablative regimen. Thiotepa may add myeloablative activity and also has the potential to cross the blood–brain barrier which may beneficial in diseases with CNS involvement (e.g., HLH) [ 38 , 39 ].…”