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Treosulfan compared to busulfan in allogeneic haematopoietic stem cell transplantation for myelofibrosis: a registry-based study from the Chronic Malignancies Working Party of the EBMT.
- Source :
-
Bone marrow transplantation [Bone Marrow Transplant] 2024 Jul; Vol. 59 (7), pp. 928-935. Date of Electronic Publication: 2024 Mar 15. - Publication Year :
- 2024
-
Abstract
- We aimed to compare outcomes following treosulfan (TREO) or busulfan (BU) conditioning in a large cohort of myelofibrosis (MF) patients from the EBMT registry. A total of 530 patients were included; 73 received TREO and 457 BU (BU ≤ 6.4 mg/kg in 134, considered RIC, BU > 6.4 mg/kg in 323 considered higher dose (HD)). Groups were compared using adjusted Cox models. Cumulative incidences of engraftment and acute GVHD were similar across the 3 groups. The TREO group had significantly better OS than BU-HD (HR:0.61, 95% CI: 0.39-0.93) and a trend towards better OS over BU-RIC (HR: 0.66, 95% CI: 0.41-1.05). Moreover, the TREO cohort had a significantly better Progression-Free-Survival (PFS) than both the BU-HD (HR: 0.57, 95% CI: 0.38-0.84) and BU-RIC (HR: 0.60, 95% CI: 0.39-0.91) cohorts, which had similar PFS estimates. Non-relapse mortality (NRM) was reduced in the TREO and BU-RIC cohorts (HR: 0.44, 95% CI: 0.24-0.80 TREO vs BU-HD; HR: 0.54, 95% CI: 0.28-1.04 TREO vs BU-RIC). Of note, relapse risk did not significantly differ across the three groups. In summary, within the limits of a registry-based study, TREO conditioning may improve PFS in MF HSCT and have lower NRM than BU-HD with a similar relapse risk to BU-RIC. Prospective studies are needed to confirm these findings.<br /> (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
- Subjects :
- Humans
Middle Aged
Male
Female
Adult
Aged
Transplantation Conditioning methods
Transplantation, Homologous methods
Graft vs Host Disease mortality
Busulfan analogs & derivatives
Busulfan therapeutic use
Primary Myelofibrosis therapy
Primary Myelofibrosis mortality
Hematopoietic Stem Cell Transplantation methods
Registries
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5365
- Volume :
- 59
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Bone marrow transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 38491198
- Full Text :
- https://doi.org/10.1038/s41409-024-02269-4