Safety and efficacy of TBF pretreatment during haploid hematopoietic stem cell transplantation
10.3760/cma.j.cn421203-20230729-00038
- VernacularTitle:单倍体造血干细胞移植TBF方案预处理的安全性和有效性研究
- Author:
Wenjuan ZHU
1
;
Shiyuan ZHOU
;
Chao MA
;
Qian ZHU
;
Jing LI
;
Xiao MA
;
Depei WU
;
Xiaojin WU
Author Information
1. 苏州大学附属第一医院血液科国家血液系统疾病临床医学研究中心江苏省血液研究所，苏州 215000
- Keywords:
Hematopoietic stem cell transplantation;
Haploidentical hematopoietic stem cell transplantation;
Pretreatment;
Safety;
Efficacy
- From:
Chinese Journal of Organ Transplantation
2024;45(2):88-95
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the safety and efficacy of TBF conditioning regimen of thiotepa, fludarabine and busulfan in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for recipients with hematological malignancies unsuitable for BUCY conditioning regimen (busulfan, cyclophosphamide & mBUCY).Method:A retrospective analysis was conducted for 20 recipients with malignant hematologic diseases receiving TBF conditioning regimen before haplo-HSCT at Soochow Hopes Hematologic Hospital from January 2020 to December 2023. The regimen-related toxicity of TBF was assessed by the Bearman scoring criteria. For comparing the safety and efficacy of TBF conditioning regimen with mBUCY regimen, propensity score matching was performed in a ratio of 1: 2 with disease type, patient age and gender as matching factors.Result:Mild oral mucositis and gastrointestinal reaction were major side-effects without severe cardiac events. Median time to neutrophil and platelet engraftments in TBF group was 11 and 18 days with comparable engraftment in mBUCY group. TBF regimen had a significantly lower incidence of grade Ⅱ-Ⅳ acute graft-versus-host disease (aGVHD) than mBUCY at Day 100 (5% vs 35%, P=0.01). No significant inter-group difference existed in overall survival (68% vs 62%, P=0.98) while 1-year incidence of graft-versus-host disease-free, relapse-free survival (GRFS) improved (63% vs 37%, P=0.06) in TBF group. Conclusion:TBF is a promising conditioning regimen with low toxicity and decent safety for haplo-HSCT. TBF patients tend to have a lower incidence of grade Ⅱ-ⅣaGVHD and better GRFS than mBUCY.
