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Thiotepa, busulfan and fludarabine conditioning regimen for adult patients with lymphoid malignancies undergoing allogeneic stem cell transplantation: a study on behalf of GETH-TC.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Peña M
  • Martinez DF
  • Paviglianiti A
  • Pascual MJ
  • Herruzo B
  • Solano C
  • Benzaquén A
  • Salas MQ
  • Rovira M
  • Español I
  • Huguet M
  • Bento L
  • Saéz AJ
  • Mussetti A

Grupos

Abstract

The efficacy of thiotepa, busulfan, and fludarabine (TBF) conditioning in lymphoproliferative disorders remains under investigation. We analyzed outcomes in 157 patients with lymphoid malignancies who underwent a first allogeneic hematopoietic stem cell transplantation (alloHCT) following TBF conditioning. Non-relapse mortality (NRM) at 3 years reached 32%, while the cumulative incidence of relapse (CIR) was 19%. At 3 years, progression-free survival (PFS), overall survival (OS), and graft-versus-host disease (GVHD)-free/relapse-free survival (GRFS) were 49.7%, 58.0%, and 44.2%, respectively. The cumulative incidences of grade III-IV acute GVHD at 100 days and moderate-to-severe chronic GVHD at 3 years were 8.3% and 12%, respectively. On multivariate analysis, patients receiving high-dose thiotepa (10 mg/kg) demonstrated a significantly lower CIR than those receiving low-dose thiotepa (5 mg/kg) (HR 2.95 [95% CI, 1.37-6.33], p = 0.006), with no significant effect on NRM. Female donor-to-male recipient transplants were associated with reduced OS (HR 2.0 [95% CI, 1.17-3.44], p = 0.011) and increased NRM (HR 2.43 [95% CI, 1.29-4.35], p = 0.005). TBF conditioning demonstrated a substantial anti-tumor effect, counterbalanced by elevated toxicity. Careful patient selection and effective toxicity mitigation strategies are essential to ensure individuals can tolerate TBF's toxicity while maximizing its benefits in disease control.

© 2025. The Author(s), under exclusive licence to Springer Nature Limited.

Datos de la publicación

ISSN/ISSNe:
0268-3369, 1476-5365

BONE MARROW TRANSPLANTATION  SPRINGERNATURE

Tipo:
Article
Páginas:
795-803
PubMed:
40175656
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
0,998 SCImago ℠
Cuartil:
Q2 SCImago ℠

Citas Recibidas en Web of Science: 3

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Keywords

  • RELAPSE-FREE SURVIVAL; BLOOD; CYCLOPHOSPHAMIDE

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