High Predicted Thiotepa Exposure is Associated with Increased Risk of Thrombotic Microangiopathy and Non-Relapse Mortality in Pediatric Patients Undergoing Alpha-Beta T-Cell Depleted Haploidentical Transplantation

Christopher C. Dvorak; Willem Collier; Soohee Cho; Lucia Holbrook-Brown; Candelaria Deimundo Roura; Julie‐An Talano; Anant Vatsayan; Nahal Lalefar; Eric Anderson; Timothy Olson; Christine S. Higham; Paibel Aguayo-Hiraldo; Neena Kapoor; Julie M Waldhart; Maryanne C Odinakachukwu; David A. Jacobsohn; Ron J. Keizer; Jordan Brooks; Michael A Pulsipher; Janel R. Long-Boyle

doi:10.1016/j.jtct.2026.08.011

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Abstract

of 45 mg·h/L was well below the median of 50.3, suggesting that the conventional regimen of 5 mg/kg × 2 doses may be supra-therapeutic for many patients. Model-based dosing of thiotepa to achieve optimal exposure may lower toxicity and improve outcomes and should be tested in prospective trials.

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Dvorak et al. (2026) studied this question.

synapsesocial.com/papers/6aa4d565af1d3d7e5b0a49d1 https://doi.org/10.1016/j.jtct.2026.08.011

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High Predicted Thiotepa Exposure is Associated with Increased Risk of Thrombotic Microangiopathy and Non-Relapse Mortality in Pediatric Patients Undergoing Alpha-Beta T-Cell Depleted Haploidentical Transplantation

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Abstract

Discussion

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High Predicted Thiotepa Exposure is Associated with Increased Risk of Thrombotic Microangiopathy and Non-Relapse Mortality in Pediatric Patients Undergoing Alpha-Beta T-Cell Depleted Haploidentical Transplantation

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Abstract

Discussion

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