Thiotepa-busulfan-fludarabine as a conditioning regimen for patients with myelofibrosis undergoing allogeneic hematopoietic transplantation: a single center experience

Leuk Lymphoma. 2021 Feb;62(2):419-427. doi: 10.1080/10428194.2020.1827246. Epub 2020 Oct 5.

Abstract

We assessed the outcomes associated with thiotepa, busulfan and fludarabine (TBF) conditioning regimen in a cohort of 29 consecutive patients allografted for myelofibrosis (MF). The median age was 56 (range 42-70) years. According to the refined Dynamic International Prognostic Scoring System (DIPSS-plus), 15 (52%) patients were classified as high risk. Graft source was peripheral blood stem cells in 27 patients. Donor type was HLA-matched related (n = 5), matched unrelated (n = 16), mismatched unrelated (n = 1), and haploidentical (n = 7). All but 2 patients engrafted. The cumulative incidence (CI) of grade II-IV acute graft-versus-host disease (GVHD) was 21% (95% CI, 10-42) at day 100. The CI of chronic GVHD was 39% (95% CI, 23-65) at 3 years. The median follow-up period was 39 (range 14-60) months. Overall survival was 69% (95% CI, 50-83) at 3 years. No relapse was observed. TBF is a valid conditioning strategy in patients with MF.

Keywords: HSCT; TBF; Thiotepa; busulfan; fludarabine; myelofibrosis.

MeSH terms

  • Adult
  • Aged
  • Busulfan / adverse effects
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Middle Aged
  • Primary Myelofibrosis* / diagnosis
  • Primary Myelofibrosis* / therapy
  • Thiotepa
  • Transplantation Conditioning
  • Vidarabine / analogs & derivatives

Substances

  • Thiotepa
  • Vidarabine
  • Busulfan
  • fludarabine