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. 2022 Jul;57(7):1164-1170.
doi: 10.1038/s41409-022-01701-x. Epub 2022 May 10.

Treosulfan plus fludarabine versus TEAM as conditioning treatment before autologous stem cell transplantation for B-cell Non-Hodgkin lymphoma

Jochen J Frietsch  1 , Jenny Miethke  2 , Paul Linke  2 , Carl C Crodel  2 , Ulf Schnetzke  2 , Sebastian Scholl  2 , Andreas Hochhaus  2 , Inken Hilgendorf  2
Affiliations

Treosulfan plus fludarabine versus TEAM as conditioning treatment before autologous stem cell transplantation for B-cell Non-Hodgkin lymphoma

Jochen J Frietsch et al. Bone Marrow Transplant. 2022 Jul.

Abstract

Conditioning with treosulfan and fludarabine (Treo/Flu) has been proven to be feasible and efficient in several types of malignancies before allogeneic hematopoietic stem cell transplantation (allo-HSCT). Given its favorable reduced toxicity profile, we introduced Treo/Flu as conditioning before autologous HSCT (auto-HSCT) in patients with B-cell Non-Hodgkin lymphoma (NHL). The aim of this study was to evaluate the efficacy and safety of Treo/Flu in comparison to TEAM. Fifty-seven patients with NHL received auto-HSCT after conditioning with either Treo/Flu (n = 22) or TEAM (n = 35). All patients achieved sustained engraftment. PFS, EFS and OS were not significant in both groups. Of note is that patients in the Treo/Flu group were less dependent on thrombocyte transfusions (p = 0.0082), significantly older (in median 11 years, p < 0.0001) and suffered less frequently from infectious complications (p = 0.0105), mucositis and stomatitis (p < 0.0001). This study is the first to present efficacy, feasibility, and safety of conditioning with Treo/Flu preceding auto-HSCT in patients with NHL. Since it demonstrated a lack of significant difference in comparison to TEAM conditioning it might be a valuable alternative especially in elderly patients with B-cell NHL and comorbidities. Further evaluation by prospective clinical trials is warranted.

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Conflict of interest statement

IH received honoraria from Novartis and ABBVIE and has obtained travel, accommodation or expenses from medac GmbH, Janssen-Ciliag, Jazz Pharmaceuticals and Celgene. AH received research support by Novartis, BMS, Pfizer, and Incyte. The other authors do not declare any conflicts of interest.

Figures

Fig. 1
Fig. 1. Outcomes of autologous stem cell transplantation after conditioning with TEAM (black line) or Treo/Flu (red line) in 57 patientes with R/R lymphoma.
a Progression free survival (PFS), b Event free survival (EFS), and c Overall survival (OS). HDT High-dose chemotherapy, TEAM Myeloablative conditioning, Treo/Flu Reduced-intensity conditioning, figures in bold indicate significant p-values.
See this image and copyright information in PMC

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