Document Detail

Treosulfan/fludarabine: a new conditioning regimen in allogeneic transplantation.
MedLine Citation:
PMID:  15124679     Owner:  NLM     Status:  MEDLINE    
Recently, the water-soluble bifunctional alkylating agent treosulfan demonstrated broad stem cell toxicity, immunosuppressive as well as antileukemic activity. Due to its well known low non-hematologic toxicity profile, treosulfan was considered an alternative agent for conditioning prior to allogeneic transplantation. A first clinical study, combining 3 x 10 g/m2 of treosulfan with 5 x 30 mg/m2 of fludarabine, demonstrated the feasibility of this conditioning. A fast, reliable and complete development of the donor hematopoiesis was evident as well as a low non-hematologic toxicity, transplantation-related mortality and relapse rate. In a second study treosulfan was escalated from 3 x 10 to 3 x 12 and 3 x 14 g/m2. In this protocol, 55 pts (patients) not amenable to standard conditioning suffering from various hematological malignancies were included. Complete donor chimerism was reached by day 28 in 80% of the pts. So far, 8 pts (11%) died without disease progression and 11 pts (20%) relapsed. Treosulfan was very well tolerated. Especially no hepatic VOD, severe cardiac or pulmonary toxicity was noted. Acute GvHD (degrees 11-IV) occurred in 44% and chronic GvHD in 45% of pts. Considering the poor prognosis of these study populations, treosulfan-based conditioning is considered to be safe and efficient. New phase 11 clinical protocols in AML and MDS will be initiated.
J Casper; W Knauf; I Blau; T Ruutu; L Volin; H Wandt; K Schafer-Eckart; J Holowiecki; S Giebel; J Aschan; A Zander; N Kroger; G Doelken; M Freund
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Annals of hematology     Volume:  83 Suppl 1     ISSN:  0939-5555     ISO Abbreviation:  Ann. Hematol.     Publication Date:  2004  
Date Detail:
Created Date:  2004-05-04     Completed Date:  2004-06-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  S70-1     Citation Subset:  IM    
University of Rostock, Germany.
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MeSH Terms
Busulfan / analogs & derivatives*,  therapeutic use*
Leukemia / classification,  therapy*
Leukemia, Myeloid, Acute / drug therapy
Leukocyte Transfusion*
Lymphoma / classification,  therapy*
Myelodysplastic Syndromes / drug therapy
Stem Cell Transplantation*
Transplantation Conditioning / methods*
Transplantation, Homologous / immunology*,  methods*
Vidarabine / analogs & derivatives*,  therapeutic use*
Reg. No./Substance:
21679-14-1/fludarabine; 299-75-2/treosulfan; 55-98-1/Busulfan; 5536-17-4/Vidarabine

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