Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Meeting Report
  • Published:

Third EBMT/AMGEN Workshop on reduced-intensity conditioning allogeneic haemopoietic stem cell transplants (RIC-HSCT), and panel consensus

Bone Marrow Transplantation volume 33, pages 691–696 (2004)Cite this article

Summary:

The Third Workshop on reduced intensity conditioning allogeneic stem cell transplants (RIC-HSCT) was convened by EBMT/AMGEN in Zurich in February 2003. Three general issues were addressed: the age effect, graft-versus-host disease (GvHD) and donor lymphocyte infusions (DLI). An age effect is seen and has a negative impact on survival; GvHD remains an issue that needs to be addressed, and DLI were shown to be a powerful tool against minimal residual disease, but not with rapidly progressing leukemia. The role of host antigen-presenting cells in the development of acute GvHD was outlined and discussed in the animal model. The emerging importance of Epstein Barr Virus infections was also discussed. Retrospective and prospective studies from the EBMT, national groups and single institutions included over 1800 patients: the incidence of acute GvHD grade III–IV was 11% extensive chronic GvHD 22% and TRM 20%. Most conditioning regimens include fludarabine in association with a reduced dose of a myeloablative agent (busulfan, TBI, thiotepa or melphalan). Most transplants were from HLA-identical siblings (77%), and used peripheral blood (90%) as a stem cell source. A consensus discussion on current evidence in RIC transplants is reported in this paper.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Bacigalupo A . Hematopoietic stem cell transplants after reduced intensity conditioning regimen (RI-HSCT): report of a workshop of the European Group for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 2000; 25: 803–805.

    Article  CAS  Google Scholar 

  2. Bacigalupo A . Second EBMT Workshop on reduced intensity allogeneic hemopoietic stem cell transplants (RI-HSCT). Bone Marrow Transplant 2002; 29: 191–195.

    Article  CAS  Google Scholar 

  3. 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.

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  5. Ordemann R, Hutchinson R, Friedman J et al. Enhanced allostimulatory activity of host antigen presenting cells in old mice intensifies graft vs host disease. J Clin Invest 2002; 109: 1249–1256.

    Article  CAS  Google Scholar 

  6. Robinson S, Goldstone AH, Mackinnon S et al. Chemoresistant or aggressive lymphoma predicts for a poor outcome following reduced-intensity allogeneic progenitor cell transplantation: an analysis from the Lymphoma Working Party of the European Group for Blood and Bone Marrow Transplantation. Blood 2002; 100: 4310–4316.

    Article  CAS  Google Scholar 

  7. Gahrton G, Svensson H, Cavo M et al. Progress in allogeneic bone marrow and peripheral blood stem cell transplantation for multiple myeloma: a comparison between transplants performed 1983–93 and 1994–98 at European Group for Blood and Marrow Transplantation centers. Br J Haematol 2001; 113: 209–216.

    Article  CAS  Google Scholar 

  8. Crawley C . Reduced intensity conditioning for patients with chronic myeloid leukemia A study of the WBMT CLWP. Blood 2002; 100: 144a.

    Google Scholar 

  9. 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  Google Scholar 

  10. Storb R, Yu C, Sanmeier BM et al. Mixed hemopoietic chimerism after marrow allografts. Transplantation in the ambulatory care setting. Ann NY Acad Sci 1999; 872: 372–375.

    Article  CAS  Google Scholar 

  11. 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  Google Scholar 

  12. Kottaridis PD, Chakravety R, Milligan DW et al. A non-myeloablative regimen for allogeneic stem cell transplantation with a low incidence of GVHD. Bone Marrow Transplant 2000; 25: S26.

    Article  Google Scholar 

  13. Corradini P, Tarella C, Olivieri A et al. Reduced-intensity conditioning followed by allografting of hematopoietic cells can produce clinical and molecular remissions in patients with poor-risk hematologic malignancies. Blood. 2002; 99: 75–82.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This Workshop was organized with an unrestricted educational grant by AMGEN Europe. I am grateful to my co-chairperson Shimon Slavin for his contribution, as well as to all discussants: David Nachbaur, Lars Vindelov, Tapani Ruutu, Didier Blaise, Jean-Michel Boiron, Mauricette Michallet, Dietger Niederwieser, Rainer Ordemann, Norbert Schmitz, Hubert Schrezenmeier, Alexander Knuth, Shimon Slavin, Benedetto Bruno, Paolo Corradini, Giorgio Dini, Maria Teresa Van Lint, Jan Cornelissen, Anton Shattenberg, Leo Verdonk, Manuel Abecasis, José A Peréz Simon, Jorge Sierra, Felipe Prosper, Lisbeth Barkholt, Bo Bjorkstrand, Alois Gratwohl, Taner Demirer, Charles Crawley, Karl Peggs, Martin Wright and David Calland.

Author information

Authors and Affiliations

  1. Divisione Ematologia 2, Ospedale San Martino, Genova, Italy

    A Bacigalupo

Authors
  1. A Bacigalupo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Bacigalupo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bacigalupo, A. Third EBMT/AMGEN Workshop on reduced-intensity conditioning allogeneic haemopoietic stem cell transplants (RIC-HSCT), and panel consensus. Bone Marrow Transplant 33, 691–696 (2004). https://doi.org/10.1038/sj.bmt.1704416

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704416

Keywords

This article is cited by

Search

Advanced search

Quick links