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Treosulfan + Total Marrow Irradiation + Fludarabine + Rapamycin + Mycophenolate Mofetil
- Development stage
- Unknown
- Lead developer
- IRCCS Ospedale San Raffaele
- Modality
- Monoclonal Antibodies → Antibody-Based Therapeutics, Small Molecules
- Administration
- Intravenous, Oral
01
Overview
TrRaMM-TMI is an experimental conditioning regimen developed by the IRCCS San Raffaele Scientific Institute for patients with high-risk hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). The regimen integrates Total Marrow Irradiation (TMI), delivered via helical tomotherapy, with a chemotherapy backbone of Treosulfan and Fludarabine. To prevent graft-versus-host disease (GvHD), the protocol utilizes a non-calcineurin inhibitor-based prophylaxis consisting of Rapamycin (sirolimus) and Mycophenolate mofetil, often supplemented with Antithymocyte globulin (ATG) and Rituximab. This approach is designed to enhance the anti-leukemic effect through targeted radiation dose escalation while minimizing the systemic toxicities typically associated with conventional total body irradiation (TBI).
- Other names
- Treosulfan-TMITrRaMM-TMI regimenTreosulfan-TMI-IRCCS San Raffaele-acute myeloid leukemia-acute lymphoblastic leukemia-multiple myeloma
02
Targets
Mechanistic target of rapamycin complex 1IMPDH (Inosine-5'-monophosphate dehydrogenase 1)DNA
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