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Sunisha Arora: New EBMT Recommendations Transform the Approach to HSCT in Thalassemia
Sunisha Arora/LinkedIn
Aug 27, 2026, 11:08

Sunisha Arora: New EBMT Recommendations Transform the Approach to HSCT in Thalassemia

Sunisha Arora, Consultant Pediatric Hematologist-Oncologist at Fortis Memorial Research Institute – India, shared a post on LinkedIn about a recent article by Mohammed Essa et al, published in Bone Marrow Transplantation, adding:

“New EBMT Recommendations 2026: HSCT Conditioning in Transfusion-Dependent Thalassemia (TDT)

1. HSCT remains a curative standard for TDT, with DFS greater than 90 percent in favorable-risk children with matched sibling donors.

2. Earlier transplant matters: Optimal pediatric outcomes are seen when HSCT is performed at less than or equal to 14 years

3. Don’t delay HSCT just to reduce iron burden.

4. Pre-HSCT optimization: In suboptimally transfused children, maintain pre-transfusion Hb around 10.5–11 g/dL for greater than or equal to 2 months to suppress ineffective erythropoiesis.

5. Treosulfan is firmly established: Treo plus Fludarabine plus Thiotepa plus ATG provides outcomes comparable to busulfan-based conditioning.

6. Busulfan plus Fludarabine remains standard, usually combined with thiotepa or low-dose cyclophosphamide.

7. Avoid TBI-based conditioning in TDT because of long-term toxicity.

8. Routine prophylactic defibrotide is NOT recommended for VOD prevention.

9. Haploidentical HSCT is now considered a valid alternative for children without matched donor.

10. Both TCRαβ-depleted haplo-HSCT and PTCy platforms are acceptable.

11. Routine splenectomy should be avoided.”

Title: Conditioning regimen for hematopoietic cell transplant in transfusion dependent thalassemia: Recommendations from the EBMT practice harmonisation and guidelines committee

Authors: Mohammed Essa, Mattia Algeri, Mohsen Alzahrani, Francoise Bernaudin, Victoria Bordon, Sonali Choudhury, Josu de la Fuente, Fabio Giglio, Erfan Nur, Valeria Maria Pinto, Francesco Onida, Annalisa Ruggeri, Isabel Sánchez-Ortega, Akif Yesilipek, Ibrahim Yakoub-Agha, Emanuele Angelucci

Sunisha Arora: New EBMT Recommendations Transform the Approach to HSCT in Thalassemia

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Akif Yesilipek Annalisa Ruggeri Bone marrow transplantation EBMT Emanuele Angelucci Erfan Nur Fabio Giglio Fludarabine Francesco Onida Francoise Bernaudin Health Hematology Hemostasis Hemostasis News Hemostasis Today HSCT Ibrahim Yakoub-Agha Isabel Sánchez-Ortega Josu de la Fuente Mattia Algeri Medicine Mohammed Essa Mohsen Alzahrani PTCy Sonali Choudhury Sunisha Arora TDT Thiotepa Transfusion-dependent thalassemia Valeria Maria Pinto Victoria Bordon
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