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Reduced Intensity Conditioning Regimens

High complete response rate after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimens in advanced malignant lymphoma

Bone Marrow Transplantation volume 32, pages 131–137 (2003)Cite this article

Summary:

The possible advantage of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a graft-versus-lymphoma effect. We explored the feasibility and efficacy of allo-HSCT with reduced-intensity (RI) regimens in advanced malignant lymphoma (ML). A total of 20 patients with indolent (n=9) or aggressive lymphoma (n=11) received allo-HSCT with an RI regimen (RIST). The preparative regimen consisted of a combination of purine analog and alkylating agent with or without antithymocyte globulin. A total of 11 patients had chemorefractory disease, seven had chemosensitive relapsed disease and two had residual disease. All of the patients received G-CSF-mobilized blood stem cells from HLA-matched siblings. Of the 20 patients, 19 achieved engraftment with acceptable regimen-related toxicities. Seven patients developed grade II–IV acute GVHD and 15 developed chronic GVHD. Of the 15 patients with evaluable disease, 12 achieved a complete response. One died of invasive fusariosis, four subsequently died of GVHD complicated with fungal infection and one died of progressive disease. With a median follow-up of 358 days, the Kaplan–Meier estimates for 1-year overall and progression-free survival were both 70%. The high response rate with low relapse observed in this study suggests that RIST may be an effective alternative curative treatment for patients with advanced ML.

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Acknowledgements

We thank the Stem Cell Transplant Unit nursing staff for providing excellent patient care.

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  1. T E Tanimoto and E Kusumi: These authors contributed equally to this work.

Authors and Affiliations

  1. Hematopoietic Stem Cell Transplant Unit, National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, Japan

    T E Tanimoto, T Hamaki, M Kami, Y Kanda, T Ando, S Yoshihara, S Masuo, S-W Kim, K Nakai, R Tanosaki, S Mineishi & Y Takaue

  2. Department of Hematology, Toranomon Hospital, Tsukiji, Chuo-ku, Tokyo, Japan

    E Kusumi, K Yuji, J Ueyama, S Miyakoshi, S Morinaga & Y Muto

  3. Hematology Division, National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, Japan

    K Tobinai

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Tanimoto, T., Kusumi, E., Hamaki, T. et al. High complete response rate after allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimens in advanced malignant lymphoma. Bone Marrow Transplant 32, 131–137 (2003). https://doi.org/10.1038/sj.bmt.1704118

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