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Acute Leukemia Forum 2000, Advances and Controversies in the Therapy of Acute Myelogenous Leukemia

Nonmyeloablative preparative regimens: how relevant for acute myelogenous leukemia?

Leukemia volume 15, pages 662–663 (2001)Cite this article

In the major histocompatibility identical setting of a marrow transplant, two barriers must be overcome. One is the rejection barrier, or host-versus-graft reaction; the other is the graft-versus-host reaction. Both processes are mediated by T lymphocytes, suggesting that agents which were effective in controlling graft-versus-host reactions might also be able to modulate host-versus-graft reactions, thereby allowing minimization of the pretransplant high-dose therapy aimed at myeloablation.

Animal models have demonstrated a dose–response relationship with respect to total body irradiation (TBI) and engraftment. In dogs, a single dose of 920 cGy, corresponding to 1500 cGy fractionated TBI, results in engraftment in virtually all of the animals. When the dose is decreased by 50%, the majority of animals reject their grafts. Using this dose, the addition of prednisone did not enhance engraftment, but cyclosporine given for 5 weeks led to engraftment in all of the animals. When the radiation dose was decreased further to 200 cGy, cyclosporine only allowed engraftment for 3–4 months, after which the grafts were rejected. The combination of methotrexate and cyclosporine resulted in engraftment in 2/5 animals, but the rest rejected.

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  1. Clinical Research Division, and Department of Medicine, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA

    R Storb

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Storb, R. Nonmyeloablative preparative regimens: how relevant for acute myelogenous leukemia?. Leukemia 15, 662–663 (2001). https://doi.org/10.1038/sj.leu.2402034

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