{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:11:29Z","timestamp":1787497889175,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,7,26]],"date-time":"2022-07-26T00:00:00Z","timestamp":1658793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Busulfan and cyclophosphamide (BuCy)\u2010based regimen has been used as a standard myeloablative chemotherapy for haematopoietic stem cell transplantation in thalassemia. However, treosulfan\u2010based conditioning regimen has emerged due to concerns of toxicities. We retrospectively analysed the safety and efficacy of fludrabine\/Bu\/Cy\/antithymocyte globulin (ATG) versus treosulfan\/thiotepa\/fludrabine regimens for Hematopoietic Stem Cell Transplant (HSCT) in transfusion\u2010dependent thalassemia (TDT) conducted at our institute (2013\u20132021). In 75 patients, 36 (48%) received Flu\/Bu\/Cy\/ATG whereas 39 (52%) received Treo\/Thio\/Flu. Median age was 6 (1\u201312) and 9 (1\u201315) years, respectively. Number of patients with Classes I, II, and III were 14, 10, and 12 in Flu\/Bu\/Cy\/ATG versus 2, 19, and 18 in Treo\/Thio\/Flu group, respectively. Graft was growth factor mobilized bone marrow in Flu\/Bu\/Cy\/ATG versus peripheral blood stem cell in Treo\/Thio\/Flu group. Mean stem cell dose was 3.82 (2.2\u20139.1) versus 5 (1.65\u20138.01)\u00a010\n                    <jats:sup>6<\/jats:sup>\n                    \/kg in Flu\/Bu\/Cy\/ATG versus Treo\/Thio\/Flu group, respectively. Neutrophils and platelets engrafted at a median of 16 (14\u201321) and 16 (9\u201347) days in Flu\/Bu\/Cy\/ATG and 15 (10\u201320) and 13 (9\u201341) days in Treo\/Thio\/Flu group. Median duration of follow\u2010up was 28 (23\u201332.9) months. Five (6.6%) patients had rejection (all secondary). Venoocclusive disease was observed in 2 (5.7%) versus 4 (10.3%) patients (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.047), respectively. Flu\/Bu\/Cy\/ATG had 4 (11.4%) patients with acute GVHD versus 15 (38.5%) patients which had significant impact on survival (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.038). We observed chronic GVHD in 4 (11.4%) and 11 (28.2%) patients, respectively, with significant impact on survival (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.031). Four (5.1%) patients had TRM in Treo\/Thio\/Flu group, in contrast to none in Flu\/Bu\/Cy\/ATG group. Mixed chimerism was common in Flu\/Bu\/Cy\/ATG {20 (57.1%)} versus Treo\/Thio\/Flu group {12 (30.1%)}. Five\u2010year Event Free Survival (EFS) and OS of entire cohort were 87%\u2009+\u20094% and 94%\u2009+\u20093%, respectively. Estimated TFS, EFS, OS of Flu\/Bu\/Cy\/ATG versus Treo\/Thio\/Flu was 97.1%\u2009+\u20092.9% versus 89.2%\u2009+\u20095.1% (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.251), 97\u2009+\u20093% versus 80.7\u2009+\u20096% (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.041) and 100% versus 90.4\u2009+\u20095% (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.067), respectively. In our experience, Flu\/Bu\/Cy\/ATG regimen is safe and effective even in high\u2010risk TDT. However, one needs to be vigilant for mixed chimerism.\n                  <\/jats:p>","DOI":"10.1111\/ejh.13825","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T04:34:50Z","timestamp":1656909290000},"page":"447-457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Busulfan and cyclophosphamide\u2010based conditioning regimen still holds the promise of being a safe and efficacious regimen for allogeneic transplantation in patients with transfusion\u2010dependent thalassemia, even in high risk"],"prefix":"10.1111","volume":"109","author":[{"given":"Pallavi","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplant Unit Rajiv Gandhi Cancer Institute and Research Centre  Delhi 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