• Leukemia & lymphoma · Aug 2020

    Feasibility of thiotepa addition to the fludarabine-busulfan conditioning with tacrolimus/sirolimus as graft vs host disease prophylaxis.

    • María Laura Fox, Irene García-Cadenas, Ariadna Martínez Pérez, Guillermo Villacampa, José Luis Piñana, Guillermo Ortí, Juan Montoro, Elisa Roldán, Anna Bosch Vilaseca, Rodrigo Martino, Olga Salamero, Silvana Saavedra, Juan Carlos Hernandez-Boluda, Albert Esquirol, Jordi Sierra, Jaime Sanz, Carlos Solano, Francesc Bosch, Pere Barba, and David Valcarcel.
    • Department of Hematology, Hospital Universitari Vall d'Hebron, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
    • Leuk. Lymphoma. 2020 Aug 1; 61 (8): 1823-1832.

    AbstractIn classical reduced-intensity conditioning (RIC) regimens, including the fludarabine and busulphan (BF) combination, sirolimus and tacrolimus (SIR-TAC) as graft vs host disease (GVHD) prophylaxis has shown acceptable results. The outcomes of SIR-TAC in a more intense RIC regimen as Thiotepa-fludarabine-busulfan (TBF) have been hardly investigated. This retrospective study included all consecutive patients receiving an allogeneic hematopoietic stem cell transplantation for myeloid malignancies (January 2009-2017) conditioned with either TBF or BF and receiving SIR-TAC. Patients receiving TBF presented higher non-relapse mortality (31.6 vs 12.3%, p = .01), along with shorter overall survival (51.8% vs 77.8%, p < .01) at 2 years than patients treated with BF. There were no significant differences in the cumulative incidence of grade II-IV acute GVHD or moderate-severe chronic GVHD or relapse between both groups. These results suggest that TBF does not seem to improve the traditional RIC BF regimen, at least when associated with SIR-TAC prophylaxis.

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