Introduction:Allogeneic hematopoietic stem cell transplantation (allo-SCT) offers the only chance of long-term remission and possibly cure for almost all hematologic malignancies. The conditioning regimen plays an important role and its choice is influenced by various factors, such as, age of patient, performance status, disease risk, and remission status at the time of transplantation.

Patients and methods: In this study, we analyzed a thiotepa-based conditioning regimen for allogeneic stem cell transplantation in adults with hematological malignancies. A total of 29 patients with different hematological malignancies were identified. The median age at transplant was 37 years (range 21-65). The transplantation was performed from a human leukocyte antigen (HLA)-matched sibling (38%) or haplo-identical donor (haplo) (62%). Disease status at transplant was first complete remission (CR1) in 49%, CR2 in 17%, CR3 in 10%. Three patients (10%) had partial response (PR), while 14% of the patients had progressive disease at the time of transplant.

Results: The incidence of acute graft-versus-host disease (aGVHD) (grade > II) was 24%, while chronic (cGVHD) occurred in 6% of the patients at 1 year. With a median follow-up of 11 months, the transplant related mortality (TRM) was 0% and 14% at 100 days and 1 year, respectively. The relapse incidence at 1 year was 20%, none of them was in CR1 at the time of transplant. The one-year progression-free survival (PFS) and overall survival (OS) were 60% and 65%, respectively. There is no statistical difference in terms of PFS, OS and TRM between patients transplanted from matched sibling donors or haplo donors. In univariate and multivariate analysis, only the increased age at transplant had a statistically significant impact on PFS and OS.

Conclusion: This study suggests that a thiotepa-based conditioning for allogeneic transplantation in high risk hematological malignancies is feasible and effective, although in the haplo setting, with the main outcomes being comparable to those achieved with other regimens.

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Disclosures

No relevant conflicts of interest to declare.

Topics:
allogeneic stem cell transplant, conditioning (psychology), thiotepa, transplantation, hematologic neoplasms, disease remission, human leukocyte antigens, allogeneic hematopoietic stem cell transplant, allopurinol, complete remission

Author notes

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Asterisk with author names denotes non-ASH members.

© 2017 by The American Society of Hematology
2017
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