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

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:

• Thiotepa
• busulfan
• fludarabine
• HSCT
• TBF
• myelofibrosis

Disclosure statement

Mohamad Mohty reports grants and/or lecture honoraria from Janssen, Sanofi, Maat Pharma, JAZZ pharmaceutical, Celgene, Amgen, BMS, Takeda, Pfizer, and Roche. Florent Malard reports lecture honoraria from Therakos/Mallinckrodt, Biocodex, Janssen, Keocyt, Sanofi, JAZZ pharmaceutical and Astellas, all outside the submitted work. Rémy Duléry reports lecture honoraria from Keocyt and Novartis.