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Non-Myeloablative Stem Cell Transplants

Dose-reduced conditioning for allogeneic blood stem cell transplantation: durable engraftment without antithymocyte globulin

Bone Marrow Transplantation volume 26, pages 119–125 (2000)Cite this article

Abstract

Between February 1998 and October 1999, 24 patients with advanced leukemia, lymphoma or solid tumors received G-CSF mobilized peripheral blood stem cells (PBSC) from HLA-matched sibling donors after dose-reduced conditioning therapy. Only patients with reduced performance status or major infectious complications, not eligible for standard transplant procedures, were included. The 5-day conditioning therapy consisted of 3.3 mg/kg intravenous busulphan × 2 days and 30 mg/m2fludarabine × 5 days. GVHD prophylaxis was performed with either CsA alone (n = 5), CsA combined with short course methotrexate (n = 5) or mycophenolate mofetil (n = 14). The day 100 survival was 95.2% for the whole group. All patients engrafted after a median of 15 days (range, 11–19) and 12.5 days (range, 10–19) for neutrophils and platelets, respectively. The median time to a neutrophil count of <0.5 × 109/l was 7 days (range, 2 to 12). acute gvhd >I was observed in six patients, whereas eight patients have signs of chronic GVHD. The prospective 12 month overall survival with a median follow-up of 7 months is 63%. Relapse of disease and toxicity associated with chronic GVHD were the main causes of death. The treatment-related mortality was 12.5%. Dose-reduced conditioning using intravenous busulphan and fludarabine allows stable engraftment without ATG in related transplants and leads to a reduction of transplant-related mortality. Bone Marrow Transplantation (2000) 26, 119–125.

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Acknowledgements

We would like to thank the Dr Mildred Scheel Stiftung ‘Deutsche Krebshilfe’ for supporting the Bone Marrow Transplantation center in Dresden.

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  1. Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    M Bornhäuser, C Thiede, U Schuler, U Platzbecker, J Freiberg-Richter, A Helwig, R Plettig, C Röllig, R Naumann, F Kroschinsky, A Neubauer & G Ehninger

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Bornhäuser, M., Thiede, C., Schuler, U. et al. Dose-reduced conditioning for allogeneic blood stem cell transplantation: durable engraftment without antithymocyte globulin. Bone Marrow Transplant 26, 119–125 (2000). https://doi.org/10.1038/sj.bmt.1702500

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