bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.18821/0234-5730/2016-61-4-172-177bloodjour-30Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESКондиционирование треосульфаном перед трансплантацией аллогенных гемопоэтических стволовых клеток у взрослых больных гемобластозамиTreosulfan-based conditioning regimen for allogeneic stem cell transplantation in adult patients with hematological malignancies is non toxic, but not myeloablativehttps://orcid.org/0000-0003-0636-4991ПоповаН. Н.PopovaN. N.

Попова Наталья Николаевна, врач-гематолог научно-клинического отделения высокодозной химиотерапии, депрессии кроветворения и трансплантации костного мозга 

125167, г. Москва

Popova Natalia N., MD, doctor-haematologist of the Research Clinical Department of the high-dose chemotherapy, depression of hematopoiesis and bone marrow transplant

Moscow, 125167

popova015@mail.ruhttps://orcid.org/0000-0001-6201-6276КузьминаЛ. А.KuzminaL. A.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0001-6177-3566ПаровичниковаЕ. Н.ParovichnikovaE. N.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0001-9431-8316ДроковМ. Ю.DrokovM. Yu.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0003-0904-7385ВасильеваВ. А.VasilyevaV. A.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0002-9372-5400МихальцоваЕ. Д.MikhaltsovaE. D.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0001-9859-2849КоролеваО. М.KorolevaO. M.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0002-2253-9870ДубнякД. С.DubnyakD. S.

125167, г. Москва

Moscow, 125167

https://orcid.org/0000-0003-2935-4040СавченкоВ. Г.SavchenkoV. G.

125167, г. Москва

Moscow, 125167

ФГБУ «Гематологический научный центр» Минздрава РоссииРоссияNational Research Center for HematologyRussian Federation201628022019614172177Copyright © Попова Н.Н., Кузьмина Л.А., Паровичникова Е.Н., Дроков М.Ю., Васильева В.А., Михальцова Е.Д., Королева О.М., Дубняк Д.С., Савченко В.Г., 20192019Попова Н.Н., Кузьмина Л.А., Паровичникова Е.Н., Дроков М.Ю., Васильева В.А., Михальцова Е.Д., Королева О.М., Дубняк Д.С., Савченко В.Г.Popova N.N., Kuzmina L.A., Parovichnikova E.N., Drokov M.Y., Vasilyeva V.A., Mikhaltsova E.D., Koroleva O.M., Dubnyak D.S., Savchenko V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/30

Основным миелоаблативным режимом кондиционирования перед трансплантацией аллогенных гемопоэтических стволовых клеток (алло-ТГСК) является режим бусульфан 16 мг/кг + циклофосфамид 120 мг/кг. Известны серьезные токсические осложнения при использовании высоких доз бусульфана, что инициировало поиск альтернативных программ. Мы исследовали режим треосульфан 36 г/м2 + циклофосфамид 120 мг/м2 как миелоаблативный у 18 больных гемобластозами из группы высокого риска (алло-ТГСК выполнена не в 1-й ремиссии, больные с неблагоприятными цитогенетическими аномалиями). Медиана возраста 27 лет (от 19 до 40 лет). В раннем посттрансплантационном периоде не было зафиксировано тяжелых токсических осложнений. Получены неплохие результаты выживаемости: в течение двух лет после алло-ТГСК общая выживаемость у больных острым миелобластным лейкозом составила 77,8%, у больных острым лимфобластным лейкозом – 66,7%. Однако на +90-й день у 8 (44,4%) из 18 больных зафиксировано отторжение трансплантата.

For many decades the main myeloablative conditioning regimen prior to allogeneic hematopoietic stem cell transplant (allo-HCT) consists of busulfan (16 mg/kg) and cyclophosphamide (120 mg/kg). The rate of transplanted-related mortality as a result of toxicity is still high. However alternative regimens are now available. These regimens allow to reduce toxicity and to get favorable outcomes. Aware of the serious toxic complications when using high doses of busulfan initiated the search for alternative programs. We studied conditioning regimen of the therapy with treosulfan 36 g/m2+ cyclophosphamide 120 mg/m2 as myeloablative, but low toxic for allo-HCT in 18 patients with hematological malignancies from the high-risk group (allo-HCT has been performed not in first remission, patients with unfavorable cytogenetic abnormalities). The median of the age was 27 years (from 19 to 40 years). During the early posttransplant period no severe toxic complications were registered in the study group. Not bad results were got during 2 years after allo-HCT. The overall survival rate in the group of patients with acute myeloid leukemia accounted for 77.8% and in the group of patients with acute lymphoblastic leukemia – 66.7%. On the day +30 full donor chimerism was detected only in 12 patients (66%). However on day +90 in 8 cases (44.4%) the graft rejection was recorded.

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The authors declare that there are no conflicts of interest present.