Long‐term outcome after a treosulfan‐based conditioning regimen for patients with acute myeloid leukemia: A report from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Abstract

Treosulfan-based conditioning regimens provide an acceptable long-term survival with favorable nonrelapse mortality and a very low risk of veno-occlusive disease. Further studies are needed to optimize the treosulfan-based conditioning regimen for patients with AML. Cancer 2017;123:2671-79. © 2017 American Cancer Society.

Intravenous Busulfan Compared with Treosulfan-Based Conditioning for Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia: A Study on Behalf of the Acute Leukemia Working Party of European Society for Blood and Marrow Transplantation

“…In all, FT14 was associated with better outcomes in patients with active disease at SCT, but this conclusion must be taken with caution because of the retrospective nature of this study and heterogeneity of the patient groups. Several prior studies found no significant differences between the various treosulfan doses [11,18,19,21]. Most found similar NRM, whereas some showed higher relapse rates in the lower dose [11].…”

“…Sjoo et al [9] have shown that treatment with treosulfan induces only a short production of IL-2 and had no effect on the synthesis of tumor necrosis factor-α and INF-γ as compared with busulfan. Bouazzaoui et al [33] showed in another murine model that conditioning with busulfan resulted in less tissue damage and lower expression of tumor necrosis factor-α than treosulfan; however, GVHD was not increased with treosulfan because of marked reduction of production of INF-γ Most prior clinical studies suggested a lower GVHD rate with treosulfan conditioning [4,14,19]. This is probably related to the cytokine milieu associated with treosulfan and to the limited mucositis with this regimen.…”

“…The combination of fludarabine and treosulfan (FT) has been introduced over the last few years [10][11][12][13][14][15][16][17][18][19][20][21]. It was reported mostly in patients with AML and MDS [10][11][12][13][14][15][16][17][18][19] but also in lymphoid malignancies [20], acute lymphoblastic leukemia, and in pediatric patients [21]. The Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) has recently reported the outcome of treosulfan-based conditioning in a relatively large group of 520 adult patients with AML [19].…”

“…It was reported mostly in patients with AML and MDS [10][11][12][13][14][15][16][17][18][19] but also in lymphoid malignancies [20], acute lymphoblastic leukemia, and in pediatric patients [21]. The Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) has recently reported the outcome of treosulfan-based conditioning in a relatively large group of 520 adult patients with AML [19]. This regimen was shown to be effective with relatively low toxicity, low rates of GVHD, and favorable outcome.…”

Treosulfan–fludarabine–thiotepa-based conditioning treatment before allogeneic hematopoietic stem cell transplantation for pediatric patients with hematological malignancies

“…However, both regimens are associated with a considerable risk of acute and late serious adverse events (AEs) [1][2][3][4][5]. Clinical studies, including prospective phase III trials in adults with AML and MDS, have shown that treosulfan-based conditioning has myeloablative, immunosuppressive, and antineoplastic effects associated with a low non-relapse mortality (NRM) [6][7][8][9][10][11]. Furthermore, several reports have been published that show an indication for treosulfan-based conditioning in children undergoing alloHSCT for nonmalignant and malignant disorders [12][13][14][15][16][17][18][19][20][21].…”