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Reduced Intensity Conditioning Regimens

A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence of graft-versus-host disease

Bone Marrow Transplantation volume 33, pages 881–889 (2004)Cite this article

Summary:

In all, 55 patients at high risk or ineligible for a conventional allogeneic hematopoietic stem cell transplant (HSCT) received a regimen consisting of extracorporeal photopheresis, pentostatin, and reduced dose total body irradiation. The median age was 49 years (18–70 years); 44 received a sibling and 11 an unrelated HSCT; 44% were over the age of 50 years and 31% had undergone a prior HSCT. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate. Full donor chimerism was documented in 98% by day +100. The 1000-day nonrelapse mortality was 11%. The median follow-up is 502 days (154–1104 days). The 1- and 2-year overall survival (OS) and event-free survival (EFS) are 67, 58 and 55%, and 47%, respectively. Patients who had not received a prior HSCT or had less than three prior chemotherapy regimens had a 71% OS and 67% EFS at 1 year. Greater than grade II aGVHD developed in 9% and chronic GVHD (cGVHD) in 43%, and extensive in 12% and limited in 31%. Of the patients, 86% who engrafted had a disease response, 72% had complete and 14% partial responses. This novel reduced intensity preparative regimen was well tolerated and associated with a low incidence of transplant-related mortality and serious acute and cGVHD.

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Acknowledgements

We thank Dr Perry Cook for his helpful discussion and critical review of the manuscript and Vickie Barthel for her editorial assistance.

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Authors and Affiliations

  1. Department of Medicine, Bone Marrow Transplantation and Hematological Malignancy Unit, Beth Israel Deaconess Medical Center, Boston, USA

    K B Miller

  2. New England Medical Center, Boston, MA

    T F Roberts, G Chan, D P Schenkein, D Lawrence, K Sprague, V Relias, H Grodman, A Mahajan & F M Foss

  3. Dana Farber Cancer Center, Boston, MA, USA

    G Gorgun

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Miller, K., Roberts, T., Chan, G. et al. A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence of graft-versus-host disease. Bone Marrow Transplant 33, 881–889 (2004). https://doi.org/10.1038/sj.bmt.1704454

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