Treosulfan
A conditioning chemotherapy given before donor stem-cell transplant in AML and MDS; it was long used in Europe and reached the US in 2025.
MC-FludT.14/L (Lancet Haematol 2020): treosulfan-fludarabine improved event-free and overall survival versus reduced-intensity busulfan-fludarabine in older/comorbid AML/MDS patients. Also used in paediatric transplant and in ovarian cancer historically (EU).
- Medicare
- Part B (clinician-administered)
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. Transplant conditioning given inpatient; paid within the Part A transplant stay.
- Commercial insurance
- covered with prior authorisation
Bundled into the transplant authorisation; centres seek approval as part of the allogeneic transplant episode.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B) · Medicare.gov: Inpatient hospital care (Part A). Not medical or financial advice; verify with your plan.
- Notes
- EU-licensed 2019 as conditioning before allogeneic transplant; used in UK paediatric protocols. NICE position not yet researched.
Sources: NICE search: treosulfan. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Approvals
| Region | Year | Indication |
|---|---|---|
| EU | 2019 | Conditioning before allogeneic HSCT (with fludarabine) in adults and children |
| US | 2025 | Preparative regimen for allogeneic HSCT in AML/MDS with fludarabine |
Trials
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Latest papers
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