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Treosulfan-based conditioning regimens for allogeneic haematopoietic stem cell transplantation in children with non-malignant diseases

Lookup NU author(s): Professor Mary Slatter, Professor Andrew GenneryORCiD

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Abstract

An increasing number of children with non-malignant diseases can be cured by allogeneic haematopoietic stem cell transplantation (HSCT). Treosulfan (L-treitol-1,4-bis-methanesulfonate) is being used more frequently for conditioning, owing to its' lower toxicity profile compared with conventional myeloablative regimens. A retrospective analysis was performed of children registered in the EBMT database, who received treosulfan before HSCT between January 2005 and 2010, to identify possible dose-related toxicity and determine the incidence of engraftment, treatment-related mortality and overall survival (OS). Results from 316 transplants from 11 different countries are presented. Ninety-five (30%) were under 1 year of age at the time of transplant. OS was 83%,and event-free survival was 76%; 3-year OS and event-free survival of infants below 1 year were 79% and 73%, respectively. No association was found with age at transplant, dose of treosulfan given, other agents used in combination with treosulfan, donor type, stem cell source, or second or subsequent transplant. In this report of the largest number of children to date receiving treosulfan for non-malignant diseases, treosulfan is shown to be a safe and effective agent even for those under 1 year of age at the time of transplant. Further prospective studies are needed using precisely defined protocols with pharmacokinetic monitoring and detailed chimerism analysis. In addition, long-term studies will be vital to determine long-term effects, for example, on fertility in comparison with other regimens.

Publication metadata

Author(s): Slatter MA, Boztug H, Potschger U, Sykora KW, Lankester A, Yaniv I, Sedlacek P, Glogova E, Veys P, Gennery AR, Peters C, EBMT Inborn Errors Paediat Dis Wor

Publication type: Article

Publication status: Published

Journal: Bone Marrow Transplantation

Year: 2015

Volume: 50

Issue: 12

Pages: 1536-1541

Print publication date: 01/12/2015

Online publication date: 10/08/2015

Acceptance date: 13/06/2015

ISSN (print): 0268-3369

ISSN (electronic): 1476-5365

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/bmt.2015.171

DOI: 10.1038/bmt.2015.171

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