Background: Allogeneic hematopoietic cell transplantation (HCT) is increasingly used as a life-saving treatment. Treosulfan based conditioning (TBC) has been used for myelobalation in children due to its low toxicity. Nevertheless, TBC has been reported to cause skin toxicity, but there is lack of data regarding its cutaneous reactions (CR).
Objective: We aimed to characterize CR of TBC in children undergoing HCT due to non-malignant diseases.
Methods: We performed an observational prospective descriptive study. Patients underwent clinical evaluation on days 0,1,7,14 following initiation of TBC. CR were classified according to their morphology and location.
Results: 15 patients participated, 100% of them developed CR following TBC. Most patients showed erythematous patches in the groin and genital area, as well as diffuse hyperpigmentation. In half of the patients, erosions were observed in the buttocks and groin. The maximal body-surface area involved with erosions was higher in children aged two years and younger (mean of 4.4%) as compared with older children (mean of 1%), but no statistical significance was found (p=0.15). In all patients the CR were self-limited.
Conclusions: This is the first prospective study documenting CR of TBC in children with non-malignant disorders undergoing HCT. CR are very common and include diffuse hyperpigementation, erythematous patches and erosions, mainly in skin folds. The majority of the CR were mild, however a tendency to develop erosions may be more common in children 2 year old and younger. The primary limitation of this study is its small sample size, which explains the lack of statistically significant results.
