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Reduced-intensity allogeneic hematopoietic stem cell transplantation for acute leukemias: ‘what is the best recipe?’

Bone Marrow Transplantation volume 36, pages 565–574 (2005)Cite this article

Summary:

Reduced-intensity stem cell transplantation (RIST) has been shown to be a safe and useful alternative transplant method for patients including elderly and medically unfit patients. RIST conditioning regimens vary widely in the intensity of myeloablation, immunoablation, and antileukemia effects, and thus optimal regimen for each disease entity is yet to be determined. Most reports on RIST to date are small, single-institution experiences or retrospective studies with heterogeneous patient populations and primary diseases, complicating any direct comparison between studies. In acute myeloid leukemia (AML), moderate-intensity regimens may be effective, achieving 30–70% 1-year disease-free survival in various series, but minimal-intensity regimens are associated with high relapse rates. In acute lymphoblastic leukemia (ALL), not even moderate-intensity regimens are effective and most patients with advanced ALL relapse post transplant. Thus, the risk/benefit ratios of graft-versus-host disease/graft-versus-leukemia effect differ among diseases. Larger, prospective, multi-center clinical trials are needed to determine the best use of RIST in hematologic malignancies.

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References

  1. Giralt S, Estey E, Albitar M et al. Engraftment of allogeneic hematopoietic progenitor cells with purine analog-containing chemotherapy: harnessing graft-versus-leukemia without myeloablative therapy. Blood 1997; 89: 4531–4536.

    CAS  PubMed  Google Scholar 

  2. McSweeney PA, Niederwieser D, Shizuru JA et al. Hematopoietic cell transplantation in older patients with hematologic malignancies: replacing high-dose cytotoxic therapy with graft-versus-tumor effects. Blood 2001; 97: 3390–3400.

    Article  CAS  PubMed  Google Scholar 

  3. Saito T, Kanda Y, Kami M et al. Therapeutic potential of a reduced-intensity preparative regimen for allogeneic transplantation with cladribine, busulfan, and antithymocyte globulin against advanced/refractory acute leukemia/lymphoma. Clin Cancer Res 2002; 8: 1014–1020.

    CAS  PubMed  Google Scholar 

  4. Slavin S, Nagler A, Naparstek E et al. Nonmyeloablative stem cell transplantation and cell therapy as an alternative to conventional bone marrow transplantation with lethal cytoreduction for the treatment of malignant and nonmalignant hematologic diseases. Blood 1998; 91: 756–763.

    CAS  PubMed  Google Scholar 

  5. Childs R, Chernoff A, Contentin N et al. Regression of metastatic renal-cell carcinoma after nonmyeloablative allogeneic peripheral-blood stem-cell transplantation. N Engl J Med 2000; 343: 750–758.

    Article  CAS  PubMed  Google Scholar 

  6. Childs R, Clave E, Contentin N et al. Engraftment kinetics after nonmyeloablative allogeneic peripheral blood stem cell transplantation: full donor T-cell chimerism precedes alloimmune responses. Blood 1999; 94: 3234–3241.

    CAS  PubMed  Google Scholar 

  7. Collins Jr RH, Shpilberg O, Drobyski WR et al. Donor leukocyte infusions in 140 patients with relapsed malignancy after allogeneic bone marrow transplantation. J Clin Oncol 1997; 15: 433–444.

    Article  PubMed  Google Scholar 

  8. Horowitz MM, Gale RP, Sondel PM et al. Graft-versus-leukemia reactions after bone marrow transplantation. Blood 1990; 75: 555–562.

    CAS  PubMed  Google Scholar 

  9. Kolb HJ, Schattenberg A, Goldman JM et al. Graft-versus-leukemia effect of donor lymphocyte transfusions in marrow grafted patients. European Group for Blood and Marrow Transplantation Working Party Chronic Leukemia. Blood 1995; 86: 2041–2050.

    CAS  PubMed  Google Scholar 

  10. Mineishi S, Schuening FG . Graft-versus-host disease in mini-transplant. Leuk Lymphoma 2004; 45: 1969–1980.

    PubMed  Google Scholar 

  11. Barnes DW, Loutit JF . Treatment of murine leukaemia with x-rays and homologous bone marrow. II. Br J Haematol 1957; 3: 241–252.

    CAS  PubMed  Google Scholar 

  12. Sullivan KM, Weiden PL, Storb R et al. Influence of acute and chronic graft-versus-host disease on relapse and survival after bone marrow transplantation from HLA-identical siblings as treatment of acute and chronic leukemia. Blood 1989; 73: 1720–1728.

    CAS  PubMed  Google Scholar 

  13. Sullivan KM, Storb R, Buckner CD et al. Graft-versus-host disease as adoptive immunotherapy in patients with advanced hematologic neoplasms. N Engl J Med 1989; 320: 828–834.

    CAS  PubMed  Google Scholar 

  14. Weiden PL, Flournoy N, Thomas ED et al. Antileukemic effect of graft-versus-host disease in human recipients of allogeneic-marrow grafts. N Engl J Med 1979; 300: 1068–1073.

    CAS  PubMed  Google Scholar 

  15. Weiden PL, Sullivan KM, Flournoy N et al. Antileukemic effect of chronic graft-versus-host disease: contribution to improved survival after allogeneic marrow transplantation. N Engl J Med 1981; 304: 1529–1533.

    CAS  PubMed  Google Scholar 

  16. Khouri IF, Keating M, Korbling M et al. Transplant-lite: induction of graft-versus-malignancy using fludarabine-based nonablative chemotherapy and allogeneic blood progenitor-cell transplantation as treatment for lymphoid malignancies. J Clin Oncol 1998; 16: 2817–2824.

    Article  CAS  PubMed  Google Scholar 

  17. Khouri IF, Saliba RM, Giralt SA et al. Nonablative allogeneic hematopoietic transplantation as adoptive immunotherapy for indolent lymphoma: low incidence of toxicity, acute graft-versus-host disease, and treatment-related mortality. Blood 2001; 98: 3595–3599.

    Article  CAS  PubMed  Google Scholar 

  18. Khouri IF, Lee MS, Saliba RM et al. Nonablative allogeneic stem-cell transplantation for advanced/recurrent mantle-cell lymphoma. J Clin Oncol 2003; 21: 4407–4412.

    CAS  PubMed  Google Scholar 

  19. Maris MB, Niederwieser D, Sandmaier BM et al. HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies. Blood 2003; 102: 2021–2030.

    Article  CAS  PubMed  Google Scholar 

  20. Feinstein LC, Sandmaier BM, Hegenbart U et al. Non-myeloablative allografting from human leucocyte antigen-identical sibling donors for treatment of acute myeloid leukaemia in first complete remission. Br J Haematol 2003; 120: 281–288.

    PubMed  Google Scholar 

  21. Bornhauser M, Thiede C, Schuler U et al. Dose-reduced conditioning for allogeneic blood stem cell transplantation: durable engraftment without antithymocyte globulin. Bone Marrow Transplant 2000; 26: 119–125.

    CAS  PubMed  Google Scholar 

  22. Chakraverty R, Peggs K, Chopra R et al. Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen. Blood 2002; 99: 1071–1078.

    CAS  PubMed  Google Scholar 

  23. Giralt S, Aleman A, Anagnostopoulos A et al. Fludarabine/melphalan conditioning for allogeneic transplantation in patients with multiple myeloma. Bone Marrow Transplant 2002; 30: 367–373.

    Article  CAS  PubMed  Google Scholar 

  24. Kottaridis PD, Milligan DW, Chopra R et al. In vivo CAMPATH-1H prevents graft-versus-host disease following nonmyeloablative stem cell transplantation. Blood 2000; 96: 2419–2425.

    CAS  PubMed  Google Scholar 

  25. Wong R, Giralt SA, Martin T et al. Reduced-intensity conditioning for unrelated donor hematopoietic stem cell transplantation as treatment for myeloid malignancies in patients older than 55 years. Blood 2003; 102: 3052–3059.

    Article  CAS  PubMed  Google Scholar 

  26. Weissinger F, Sandmaier BM, Maloney DG et al. Decreased transfusion requirements for patients receiving nonmyeloablative compared with conventional peripheral blood stem cell transplants from HLA-identical siblings. Blood 2001; 98: 3584–3588.

    CAS  PubMed  Google Scholar 

  27. Mielcarek M, Martin PJ, Leisenring W et al. Graft-versus-host disease after nonmyeloablative versus conventional hematopoietic stem cell transplantation. Blood 2003; 102: 756–762.

    CAS  PubMed  Google Scholar 

  28. Badros A, Barlogie B, Morris C et al. High response rate in refractory and poor-risk multiple myeloma after allotransplantation using a nonmyeloablative conditioning regimen and donor lymphocyte infusions. Blood 2001; 97: 2574–2579.

    CAS  PubMed  Google Scholar 

  29. Branson K, Chopra R, Kottaridis PD et al. Role of nonmyeloablative allogeneic stem-cell transplantation after failure of autologous transplantation in patients with lymphoproliferative malignancies. J Clin Oncol 2002; 20: 4022–4031.

    PubMed  Google Scholar 

  30. Marks DI, Lush R, Cavenagh J et al. The toxicity and efficacy of donor lymphocyte infusions given after reduced-intensity conditioning allogeneic stem cell transplantation. Blood 2002; 100: 3108–3114.

    CAS  PubMed  Google Scholar 

  31. Kreiter S, Winkelmann N, Schneider PM et al. Failure of sustained engraftment after non-myeloablative conditioning with low-dose TBI and T cell-reduced allogeneic peripheral stem cell transplantation. Bone Marrow Transplant 2001; 28: 157–161.

    CAS  PubMed  Google Scholar 

  32. Perez-Simon JA, Kottaridis PD, Martino R et al. Nonmyeloablative transplantation with or without alemtuzumab: comparison between 2 prospective studies in patients with lymphoproliferative disorders. Blood 2002; 100: 3121–3127.

    CAS  PubMed  Google Scholar 

  33. Perez-Simon JA, Caballero D, Diez-Campelo M et al. Chimerism and minimal residual disease monitoring after reduced intensity conditioning (RIC) allogeneic transplantation. Leukemia 2002; 16: 1423–1431.

    CAS  PubMed  Google Scholar 

  34. Niiya H, Kanda Y, Saito T et al. Early full donor myeloid chimerism after reduced-intensity stem cell transplantation using a combination of fludarabine and busulfan. Haematologica 2001; 86: 1071–1074.

    CAS  PubMed  Google Scholar 

  35. Baron F, Baker JE, Storb R et al. Kinetics of engraftment in patients with hematologic malignancies given allogeneic hematopoietic cell transplantation after nonmyeloablative conditioning. Blood 2004; 104: 2254–2262.

    CAS  PubMed  Google Scholar 

  36. Mohr B, Koch R, Thiede C et al. CD34+ cell dose, conditioning regimen and prior chemotherapy: factors with significant impact on the early kinetics of donor chimerism after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2004; 34: 949–954.

    CAS  PubMed  Google Scholar 

  37. Antin JH, Ferrara JL . Cytokine dysregulation and acute graft-versus-host disease. Blood 1992; 80: 2964–2968.

    CAS  PubMed  Google Scholar 

  38. Mattsson J, Uzunel M, Remberger M, Ringden O . T cell mixed chimerism is significantly correlated to a decreased risk of acute graft-versus-host disease after allogeneic stem cell transplantation. Transplantation 2001; 71: 433–439.

    CAS  PubMed  Google Scholar 

  39. Mineishi S, Kanda Y, Saito T et al. Impact of graft-versus-host disease in reduced-intensity stem cell transplantation (RIST) for patients with haematological malignancies. Br J Haematol 2003; 121: 296–303.

    PubMed  Google Scholar 

  40. de Lima M, Anagnostopoulos A, Munsell M et al. Nonablative versus reduced-intensity conditioning regimens in the treatment of acute myeloid leukemia and high-risk myelodysplastic syndrome: dose is relevant for long-term disease control after allogeneic hematopoietic stem cell transplantation. Blood 2004; 104: 865–872.

    CAS  PubMed  Google Scholar 

  41. Shlomchik WD, Couzens MS, Tang CB et al. Prevention of graft versus host disease by inactivation of host antigen-presenting cells. Science 1999; 285: 412–415.

    CAS  PubMed  Google Scholar 

  42. Shlomchik WD . Antigen presentation in graft-vs-host disease. Exp Hematol 2003; 31: 1187–1197.

    CAS  PubMed  Google Scholar 

  43. Teshima T, Ordemann R, Reddy P et al. Acute graft-versus-host disease does not require alloantigen expression on host epithelium. Nat Med 2002; 8: 575–581.

    CAS  PubMed  Google Scholar 

  44. Mapara MY, Kim YM, Wang SP et al. Donor lymphocyte infusions mediate superior graft-versus-leukemia effects in mixed compared to fully allogeneic chimeras: a critical role for host antigen-presenting cells. Blood 2002; 100: 1903–1909.

    CAS  PubMed  Google Scholar 

  45. Michallet M, Bilger K, Garban F et al. Allogeneic hematopoietic stem-cell transplantation after nonmyeloablative preparative regimens: impact of pretransplantation and posttransplantation factors on outcome. J Clin Oncol 2001; 19: 3340–3349.

    CAS  PubMed  Google Scholar 

  46. Mohty M, Bay JO, Faucher C et al. Graft-versus-host disease following allogeneic transplantation from HLA-identical sibling with antithymocyte globulin-based reduced-intensity preparative regimen. Blood 2003; 102: 470–476.

    CAS  PubMed  Google Scholar 

  47. Nakai K, Mineishi S, Kami M et al. Antithymocyte globulin affects the occurrence of acute and chronic graft-versus-host disease after a reduced-intensity conditioning regimen by modulating mixed chimerism induction and immune reconstitution. Transplantation 2003; 75: 2135–2143.

    CAS  PubMed  Google Scholar 

  48. Schetelig J, Bornhauser M, Kiehl M et al. Reduced-intensity conditioning with busulfan and fludarabine with or without antithymocyte globulin in HLA-identical sibling transplantation – a retrospective analysis. Bone Marrow Transplant 2004; 33: 483–490.

    CAS  PubMed  Google Scholar 

  49. Hamaki T, Kami M, Kim SW et al. Reduced-intensity stem cell transplantation from an HLA-identical sibling donor in patients with myeloid malignancies. Bone Marrow Transplant 2004; 33: 891–900.

    CAS  PubMed  Google Scholar 

  50. Bertz H, Potthoff K, Finke J . Allogeneic stem-cell transplantation from related and unrelated donors in older patients with myeloid leukemia. J Clin Oncol 2003; 21: 1480–1484.

    PubMed  Google Scholar 

  51. Martino R, Caballero MD, Simon JA et al. Evidence for a graft-versus-leukemia effect after allogeneic peripheral blood stem cell transplantation with reduced-intensity conditioning in acute myelogenous leukemia and myelodysplastic syndromes. Blood 2002; 100: 2243–2245.

    CAS  PubMed  Google Scholar 

  52. Sayer HG, Kroger M, Beyer J et al. Reduced intensity conditioning for allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia: disease status by marrow blasts is the strongest prognostic factor. Bone Marrow Transplant 2003; 31: 1089–1095.

    CAS  PubMed  Google Scholar 

  53. Hallemeier C, Girgis M, Blum W et al. Outcomes of adults with acute myelogenous leukemia in remission given 550 cGy of single-exposure total body irradiation, cyclophosphamide, and unrelated donor bone marrow transplants. Biol Blood Marrow Transplant 2004; 10: 310–319.

    CAS  PubMed  Google Scholar 

  54. Girgis M, Hallemeier C, Blum W et al. Chimerism and clinical outcomes of 110 unrelated donor bone marrow transplant recipients conditioned with low dose (550 cGy), single exposure total body irradiation and cyclophosphamide. Blood 2005; 105: 3035–3041.

    CAS  PubMed  Google Scholar 

  55. Malladi RK, Peniket AJ, Norton AE et al. Favourable outcome for patients with myeloid disorders treated with fludarabine–melphalan reduced-intensity conditioning and allogeneic bone marrow stem cell transplantation without the use of T-lymphocyte-depleting antibodies. Eur J Haematol 2004; 73: 85–92.

    CAS  PubMed  Google Scholar 

  56. Giralt S, Thall PF, Khouri I et al. Melphalan and purine analog-containing preparative regimens: reduced-intensity conditioning for patients with hematologic malignancies undergoing allogeneic progenitor cell transplantation. Blood 2001; 97: 631–637.

    CAS  PubMed  Google Scholar 

  57. Taussig DC, Davies AJ, Cavenagh JD et al. Durable remissions of myelodysplastic syndrome and acute myeloid leukemia after reduced-intensity allografting. J Clin Oncol 2003; 21: 3060–3065.

    CAS  PubMed  Google Scholar 

  58. Kataoka I, Kami M, Takahashi S et al. Clinical impact of graft-versus-host disease against leukemias not in remission at the time of allogeneic hematopoietic stem cell transplantation from related donors. The Japan Society for Hematopoietic Cell Transplantation Working Party. Bone Marrow Transplant 2004; 34: 711–719.

    CAS  PubMed  Google Scholar 

  59. Martino R, Giralt S, Caballero MD et al. Allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning in acute lymphoblastic leukemia: a feasibility study. Haematologica 2003; 88: 555–560.

    PubMed  Google Scholar 

  60. Arnold R, Massenkeil G, Bornhauser M et al. Nonmyeloablative stem cell transplantation in adults with high-risk ALL may be effective in early but not in advanced disease. Leukemia 2002; 16: 2423–2428.

    CAS  PubMed  Google Scholar 

  61. Massenkeil G, Nagy M, Lawang M et al. Reduced intensity conditioning and prophylactic DLI can cure patients with high-risk acute leukaemias if complete donor chimerism can be achieved. Bone Marrow Transplant 2003; 31: 339–345.

    CAS  PubMed  Google Scholar 

  62. Sloand E, Childs RW, Solomon S et al. The graft-versus-leukemia effect of nonmyeloablative stem cell allografts may not be sufficient to cure chronic myelogenous leukemia. Bone Marrow Transplant 2003; 32: 897–901.

    CAS  PubMed  Google Scholar 

  63. Or R, Shapira MY, Resnick I et al. Nonmyeloablative allogeneic stem cell transplantation for the treatment of chronic myeloid leukemia in first chronic phase. Blood 2003; 101: 441–445.

    CAS  PubMed  Google Scholar 

  64. Keil F, Prinz E, Moser K et al. Rapid establishment of long-term culture-initiating cells of donor origin after nonmyeloablative allogeneic hematopoietic stem-cell transplantation, and significant prognostic impact of donor T-cell chimerism on stable engraftment and progression-free survival. Transplantation 2003; 76: 230–236.

    CAS  PubMed  Google Scholar 

  65. Antin JH, Childs R, Filipovich AH et al. Establishment of complete and mixed donor chimerism after allogeneic lymphohematopoietic transplantation: recommendations from a workshop at the 2001 Tandem Meetings of the International Bone Marrow Transplant Registry and the American Society of Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2001; 7: 473–485.

    CAS  PubMed  Google Scholar 

  66. Bader P, Beck J, Frey A et al. Serial and quantitative analysis of mixed hematopoietic chimerism by PCR in patients with acute leukemias allows the prediction of relapse after allogeneic BMT. Bone Marrow Transplant 1998; 21: 487–495.

    CAS  PubMed  Google Scholar 

  67. Bader P, Kreyenberg H, Hoelle W et al. Increasing mixed chimerism is an important prognostic factor for unfavorable outcome in children with acute lymphoblastic leukemia after allogeneic stem-cell transplantation: possible role for pre-emptive immunotherapy? J Clin Oncol 2004; 22: 1696–1705.

    PubMed  Google Scholar 

  68. Bader P, Kreyenberg H, Hoelle W et al. Increasing mixed chimerism defines a high-risk group of childhood acute myelogenous leukemia patients after allogeneic stem cell transplantation where pre-emptive immunotherapy may be effective. Bone Marrow Transplant 2004; 33: 815–821.

    CAS  PubMed  Google Scholar 

  69. Khan F, Agarwal A, Agrawal S . Significance of chimerism in hematopoietic stem cell transplantation: new variations on an old theme. Bone Marrow Transplant 2004; 34: 1–12.

    CAS  PubMed  Google Scholar 

  70. Mattsson J, Uzunel M, Tammik L et al. Leukemia lineage-specific chimerism analysis is a sensitive predictor of relapse in patients with acute myeloid leukemia and myelodysplastic syndrome after allogeneic stem cell transplantation. Leukemia 2001; 15: 1976–1985.

    CAS  PubMed  Google Scholar 

  71. Molloy K, Goulden N, Lawler M et al. Patterns of hematopoietic chimerism following bone marrow transplantation for childhood acute lymphoblastic leukemia from volunteer unrelated donors. Blood 1996; 87: 3027–3031.

    CAS  PubMed  Google Scholar 

  72. Wasch R, Reisser S, Hahn J et al. Rapid achievement of complete donor chimerism and low regimen-related toxicity after reduced conditioning with fludarabine, carmustine, melphalan and allogeneic transplantation. Bone Marrow Transplant 2000; 26: 243–250.

    CAS  PubMed  Google Scholar 

  73. Zetterquist H, Mattsson J, Uzunel M et al. Mixed chimerism in the B cell lineage is a rapid and sensitive indicator of minimal residual disease in bone marrow transplant recipients with pre-B cell acute lymphoblastic leukemia. Bone Marrow Transplant 2000; 25: 843–851.

    CAS  PubMed  Google Scholar 

  74. Valcarcel D, Martino R, Caballero D et al. Chimerism analysis following allogeneic peripheral blood stem cell transplantation with reduced-intensity conditioning. Bone Marrow Transplant 2003; 31: 387–392.

    CAS  PubMed  Google Scholar 

  75. van Leeuwen JE, van Tol MJ, Joosten AM et al. Persistence of host-type hematopoiesis after allogeneic bone marrow transplantation for leukemia is significantly related to the recipient's age and/or the conditioning regimen, but it is not associated with an increased risk of relapse. Blood 1994; 83: 3059–3067.

    CAS  PubMed  Google Scholar 

  76. Maloney DG, Molina AJ, Sahebi F et al. Allografting with nonmyeloablative conditioning following cytoreductive autografts for the treatment of patients with multiple myeloma. Blood 2003; 102: 3447–3454.

    CAS  PubMed  Google Scholar 

  77. Tallman MS, Rowlings PA, Milone G et al. Effect of postremission chemotherapy before human leukocyte antigen-identical sibling transplantation for acute myelogenous leukemia in first complete remission. Blood 2000; 96: 1254–1258.

    CAS  PubMed  Google Scholar 

  78. Devine SM, Hoffman R, Verma A et al. Allogeneic blood cell transplantation following reduced-intensity conditioning is effective therapy for older patients with myelofibrosis with myeloid metaplasia. Blood 2002; 99: 2255–2258.

    CAS  PubMed  Google Scholar 

  79. Hessling J, Kroger N, Werner M et al. Dose-reduced conditioning regimen followed by allogeneic stem cell transplantation in patients with myelofibrosis with myeloid metaplasia. Br J Haematol 2002; 119: 769–772.

    PubMed  Google Scholar 

  80. Rondelli D, Barosi G, Bacigalupo A et al. Allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning in intermediate or high risk patients with myelofibrosis with myeloid metaplasia. Blood 2005; 105: 4115–4119.

    CAS  PubMed  Google Scholar 

  81. Blaise D, Bay JO, Faucher C et al. Reduced-intensity preparative regimen and allogeneic stem cell transplantation for advanced solid tumors. Blood 2004; 103: 435–441.

    CAS  PubMed  Google Scholar 

  82. Ueno NT, Cheng YC, Rondon G et al. Rapid induction of complete donor chimerism by the use of a reduced-intensity conditioning regimen composed of fludarabine and melphalan in allogeneic stem cell transplantation for metastatic solid tumors. Blood 2003; 102: 3829–3836.

    CAS  PubMed  Google Scholar 

  83. Nishio M, Nakao S, Endo T et al. Successful non-myeloablative stem cell transplantation for a heavily transfused woman with severe aplastic anemia complicated by heart failure. Bone Marrow Transplant 2001; 28: 783–785.

    CAS  PubMed  Google Scholar 

  84. Vassiliou GS, Webb DK, Pamphilon D et al. Improved outcome of alternative donor bone marrow transplantation in children with severe aplastic anaemia using a conditioning regimen containing low-dose total body irradiation, cyclophosphamide and Campath. Br J Haematol 2001; 114: 701–705.

    CAS  PubMed  Google Scholar 

  85. Hegenbart U, Niederwieser D, Forman S et al. Hematopoietic cell transplantation from related and unrelated donors after minimal conditioning as a curative treatment modality for severe paroxysmal nocturnal hemoglobinuria. Biol Blood Marrow Transplant 2003; 9: 689–697.

    CAS  PubMed  Google Scholar 

  86. Lee JL, Lee JH, Choi SJ et al. Allogeneic hematopoietic cell transplantation for paroxysmal nocturnal hemoglobinuria. Eur J Haematol 2003; 71: 114–118.

    PubMed  Google Scholar 

  87. Suenaga K, Kanda Y, Niiya H et al. Successful application of nonmyeloablative transplantation for paroxysmal nocturnal hemoglobinuria. Exp Hematol 2001; 29: 639–642.

    CAS  PubMed  Google Scholar 

  88. Iannone R, Casella JF, Fuchs EJ et al. Results of minimally toxic nonmyeloablative transplantation in patients with sickle cell anemia and beta-thalassemia. Biol Blood Marrow Transplant 2003; 9: 519–528.

    PubMed  Google Scholar 

  89. Schleuning M, Stoetzer O, Waterhouse C et al. Hematopoietic stem cell transplantation after reduced-intensity conditioning as treatment of sickle cell disease. Exp Hematol 2002; 30: 7–10.

    PubMed  Google Scholar 

  90. Oyama Y, Traynor AE, Barr W, Burt RK . Allogeneic stem cell transplantation for autoimmune diseases: nonmyeloablative conditioning regimens. Bone Marrow Transplant 2003; 32 (Suppl. 1): S81–S83.

    CAS  PubMed  Google Scholar 

  91. Jones OY, Good RA, Cahill RA . Nonmyeloablative allogeneic bone marrow transplantation for treatment of childhood overlap syndrome and small vessel vasculitis. Bone Marrow Transplant 2004; 33: 1061–1063.

    CAS  PubMed  Google Scholar 

  92. Barker JN, Weisdorf DJ, DeFor TE et al. Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning. Blood 2003; 102: 1915–1919.

    CAS  PubMed  Google Scholar 

  93. Rizzieri DA, Long GD, Vredenburgh JJ et al. Successful allogeneic engraftment of mismatched unrelated cord blood following a nonmyeloablative preparative regimen. Blood 2001; 98: 3486–3488.

    CAS  PubMed  Google Scholar 

  94. Ichinohe T, Uchiyama T, Shimazaki C et al. Feasibility of HLA-haploidentical hematopoietic stem cell transplantation between noninherited maternal antigen (NIMA)-mismatched family members linked with long-term fetomaternal microchimerism. Blood 2004; 104: 3821–3828.

    CAS  PubMed  Google Scholar 

  95. Goggins TF, Rizzieri DR . Nonmyeloablative allogeneic stem cell transplantation using alternative donors. Cancer Control 2004; 11: 86–96.

    PubMed  Google Scholar 

  96. Cornelissen JJ, Carston M, Kollman C et al. Unrelated marrow transplantation for adult patients with poor-risk acute lymphoblastic leukemia: strong graft-versus-leukemia effect and risk factors determining outcome. Blood 2001; 97: 1572–1577.

    CAS  PubMed  Google Scholar 

  97. Hansen JA, Gooley TA, Martin PJ et al. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med 1998; 338: 962–968.

    CAS  PubMed  Google Scholar 

  98. Niederwieser D, Maris M, Shizuru JA et al. Low-dose total body irradiation (TBI) and fludarabine followed by hematopoietic cell transplantation (HCT) from HLA-matched or mismatched unrelated donors and postgrafting immunosuppression with cyclosporine and mycophenolate mofetil (MMF) can induce durable complete chimerism and sustained remissions in patients with hematological diseases. Blood 2003; 101: 1620–1629 (Epub 2002 October 3).

    CAS  PubMed  Google Scholar 

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  1. Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, USA

    A A Kassim & W Chinratanalab

  2. Blood and Marrow Transplant Program, University of Michigan, Ann Arbor, USA

    J L M Ferrara & S Mineishi

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Kassim, A., Chinratanalab, W., Ferrara, J. et al. Reduced-intensity allogeneic hematopoietic stem cell transplantation for acute leukemias: ‘what is the best recipe?’. Bone Marrow Transplant 36, 565–574 (2005). https://doi.org/10.1038/sj.bmt.1705075

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