Thiotepa-containing conditioning for allogeneic hematopoietic stem cell transplantation in children with inborn errors of immunity: a retrospective clinical analysis

Xiao-Jun WU, Xia-Wei HAN, Kai-Mei WANG, Shao-Fen LIN, Li-Ping QUE, Xin-Yu LI, Dian-Dian LIU, Jian-Pei FANG, Ke HUANG, Hong-Gui XU

Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (10) : 1240-1246.

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Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (10) : 1240-1246. DOI: 10.7499/j.issn.1008-8830.2504147
CLINICAL RESEARCH

Thiotepa-containing conditioning for allogeneic hematopoietic stem cell transplantation in children with inborn errors of immunity: a retrospective clinical analysis

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Abstract

Objective To evaluate the safety and efficacy of thiotepa (TT)-containing conditioning regimens for allogeneic hematopoietic stem cell transplantation (HSCT) in children with inborn errors of immunity (IEI). Methods Clinical data of 22 children with IEI who underwent HSCT were retrospectively reviewed. Survival after HSCT was estimated using the Kaplan-Meier method. Results Nine patients received a traditional conditioning regimen (fludarabine + busulfan + cyclophosphamide/etoposide) and underwent peripheral blood stem cell transplantation (PBSCT). Thirteen patients received a TT-containing modified conditioning regimen (TT + fludarabine + busulfan + cyclophosphamide), including seven PBSCT and six umbilical cord blood transplantation (UCBT) cases. Successful engraftment with complete donor chimerism was achieved in all patients. Acute graft-versus-host disease occurred in 12 patients (one with grade III and the remaining with grade I-II). Chronic graft-versus-host disease occurred in one patient. The incidence of EB viremia in UCBT patients was lower than that in PBSCT patients (P<0.05). Over a median follow-up of 36.0 months, one death occurred. The 3-year overall survival (OS) rate was 100% for the modified regimen and 88.9% ± 10.5% for the traditional regimen (P=0.229). When comparing transplantation types, the 3-year OS rates were 100% for UCBT and 93.8% ± 6.1% for PBSCT (P>0.05), and the 3-year event-free survival rates were 100% and 87.1% ± 8.6%, respectively (P>0.05). Conclusions TT-containing conditioning for allogeneic HSCT in children with IEI is safe and effective. Both UCBT and PBSCT may achieve high success rates.

Key words

Allogeneic hematopoietic stem cell transplantation / Thiotepa / Inborn error of immunity / Umbilical cord blood / Child

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Xiao-Jun WU , Xia-Wei HAN , Kai-Mei WANG , et al . Thiotepa-containing conditioning for allogeneic hematopoietic stem cell transplantation in children with inborn errors of immunity: a retrospective clinical analysis[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(10): 1240-1246 https://doi.org/10.7499/j.issn.1008-8830.2504147

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