thiotepa at a glance
Medicine class
Cytotoxic alkylating agent
Main role
Conditioning before autologous or allogeneic stem-cell transplantation
Administration
Hospital intravenous infusion through a central venous catheter
Key safety issue
Profound bone-marrow suppression with increased infection and bleeding risk
What is thiotepa used for?
Licensed uses in combination with other chemotherapy are:
Conditioning, with or without total-body irradiation, before autologous or allogeneic haematopoietic progenitor-cell transplantation for blood disorders in adults and children.
High-intensity chemotherapy supported by haematopoietic progenitor-cell transplantation for solid tumours in adults and children.
How does thiotepa work?
Thiotepa forms reactive compounds that attach to and disrupt DNA. This prevents cells from dividing and strongly suppresses bone marrow and immune cells, helping transplanted stem cells to engraft.
thiotepa preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 15 mg, 100 mg
How to take thiotepa
Thiotepa is not taken by mouth. A qualified healthcare professional prepares and dilutes the powder, then gives it into a central vein in hospital. Food does not affect its administration.
The infusion solution requires aseptic preparation and an in-line filter.
Tell the team promptly about pain or inflammation around the infusion site.
Do not drive or operate machinery if dizziness, headache or blurred vision occurs.
thiotepa side effects
Common or expected effects
- Low white cells, platelets and red cells, increasing infection, bleeding and anaemia risks
- Nausea, vomiting, diarrhoea, abdominal discomfort and reduced appetite
- Sore mouth or inflammation of other mucosal surfaces
- Rash, itching and hair loss
- Fever, chills, weakness, headache or dizziness
- Changes in liver tests
Get urgent medical advice
- Sepsis or another severe infection
- Severe bleeding or profound blood-cell suppression
- Liver injury, including hepatic veno-occlusive disease
- Pneumonitis, pulmonary oedema or other serious breathing complications
- Seizures, encephalopathy or leukoencephalopathy
- Severe allergic or blistering skin reactions
- Cardiac, kidney or multi-organ failure
thiotepa in pregnancy
Thiotepa is contraindicated during pregnancy because it may seriously harm an embryo or fetus. Pregnancy testing is required before treatment, and effective contraception is needed during treatment and for the product-specified period afterwards. Discuss fertility preservation before treatment where relevant.
thiotepa while breastfeeding
Breastfeeding is contraindicated during treatment. It is unknown whether thiotepa enters human milk, but serious toxicity to a breastfed infant is possible. Specialist advice is needed about future feeding plans.
thiotepa interactions
The transplant team should review all prescribed, non-prescribed and complementary products before treatment.
Yellow-fever and other live vaccines
Contraindicated because immunosuppression can allow serious or fatal vaccine-derived infection.
Phenytoin or fosphenytoin
May alter seizure control and thiotepa exposure; concurrent use is not recommended.
Cyclophosphamide
Must not run concurrently in the same conditioning programme; thiotepa is administered only after the cyclophosphamide infusion is complete.
Common questions about thiotepa
Answers are fully visible for fast scanning and source review.
Why is thiotepa given before a stem-cell transplant?
It suppresses or destroys existing marrow and immune cells, helping prepare for engraftment of transplanted stem cells.
Is thiotepa chemotherapy?
Yes. It is a cytotoxic alkylating chemotherapy.
Can adults and children receive thiotepa?
Yes. Its licensed transplant-conditioning indications include adults and children.
Why are blood tests needed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.