Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center
: Myeloablative-allogeneic stem cell transplantation is a common way of treating various malignant and nonma-lignant diseases; but, it is associated with hazardous immediate and late complications. The majority of patients are not good candidates for high dose therapy because of old age, medical co-...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2004-08-01
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| Series: | International Journal of Hematology-Oncology and Stem Cell Research |
| Subjects: | |
| Online Access: | http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/4492.pdf&manuscript_id=4492 |
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| author | Keyhanian S Ghavamzadeh A Bahar B Alimoghaddam K Shamshiri AR Gholibeikian.S |
| author_facet | Keyhanian S Ghavamzadeh A Bahar B Alimoghaddam K Shamshiri AR Gholibeikian.S |
| author_sort | Keyhanian S |
| collection | DOAJ |
| description | : Myeloablative-allogeneic stem cell transplantation is a common way of treating various malignant and nonma-lignant diseases; but, it is associated with hazardous immediate and late complications. The majority of patients are not good candidates for high dose therapy because of old age, medical co-morbidities or previous heavy treatments. The donor stem cells can engraft in the recipient and induce mixed chimerism when we use a less intensive, but sufficiently immunosup-pressive, conditioning regimen, known as mini-transplantation or non-Myeloablative allogeneic Stem Cell Transplantation (NM-allo-SCT)."nMethods: The conditioning regimens were the combination of Fludarabine and Cyclophosphamide or Busulfan and ATG. Prophylaxis against graft versus host disease (GVHD) included Cyclosporine A (CSA) +/- Methotrexate. A multiplex-PCR using short tandem repeats (VNTR) was used for chimerism analysis."nResults: We report the results of NM-allo-SCT from the HLA-identical siblings in 20 patients with AML (N=7), CML (N=6), NHL (N=2), MDS (N=2), ALL (N=1) and Fanconi anemia (N=2). Fourteen males and 6 females with median age of 43 years (range 8-55) underwent NM-allo-SCT and were followed up 4-870 days (median 420 days). Typical side effect of conventional HSCT, such as severe mucositis, vomiting and VOD were absent. Most of the patients did not become se¬verely pancytopenic and had relatively short hospitalization. Hematological recovery was rapid, a median of 8.5 days. Acute GVHD (grade ≥II) and extensive chronic GVHD was observed in three patients. Most of the patients initially had mixed-chimerism, progressing to full-donor-chimerism in 11 patients, after the interruption of the CSA therapy, and, in one patient, after DLI. Nine patients died, six from relapse or disease progression and three from transplantation-related complications (GVHD, infection or secondary malignancy). 14 month overall survival and disease free survival of 55% and 50%, respec¬tively, was observed."nConclusion: Our results confirm that NM-allo-SCT is safe and minimally toxic and is a potential new approach for a safer treatment of a large variety of hematologic diseases, especially in patients with AML and CML in remission. |
| first_indexed | 2024-03-12T19:40:52Z |
| format | Article |
| id | doaj.art-eae6d5016f6347f681a82afa53c60e43 |
| institution | Directory Open Access Journal |
| issn | 2008-3009 2008-2207 |
| language | English |
| last_indexed | 2024-03-12T19:40:52Z |
| publishDate | 2004-08-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | International Journal of Hematology-Oncology and Stem Cell Research |
| spelling | doaj.art-eae6d5016f6347f681a82afa53c60e432023-08-02T03:52:28ZengTehran University of Medical SciencesInternational Journal of Hematology-Oncology and Stem Cell Research2008-30092008-22072004-08-01121114Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search CenterKeyhanian SGhavamzadeh ABahar BAlimoghaddam KShamshiri ARGholibeikian.S: Myeloablative-allogeneic stem cell transplantation is a common way of treating various malignant and nonma-lignant diseases; but, it is associated with hazardous immediate and late complications. The majority of patients are not good candidates for high dose therapy because of old age, medical co-morbidities or previous heavy treatments. The donor stem cells can engraft in the recipient and induce mixed chimerism when we use a less intensive, but sufficiently immunosup-pressive, conditioning regimen, known as mini-transplantation or non-Myeloablative allogeneic Stem Cell Transplantation (NM-allo-SCT)."nMethods: The conditioning regimens were the combination of Fludarabine and Cyclophosphamide or Busulfan and ATG. Prophylaxis against graft versus host disease (GVHD) included Cyclosporine A (CSA) +/- Methotrexate. A multiplex-PCR using short tandem repeats (VNTR) was used for chimerism analysis."nResults: We report the results of NM-allo-SCT from the HLA-identical siblings in 20 patients with AML (N=7), CML (N=6), NHL (N=2), MDS (N=2), ALL (N=1) and Fanconi anemia (N=2). Fourteen males and 6 females with median age of 43 years (range 8-55) underwent NM-allo-SCT and were followed up 4-870 days (median 420 days). Typical side effect of conventional HSCT, such as severe mucositis, vomiting and VOD were absent. Most of the patients did not become se¬verely pancytopenic and had relatively short hospitalization. Hematological recovery was rapid, a median of 8.5 days. Acute GVHD (grade ≥II) and extensive chronic GVHD was observed in three patients. Most of the patients initially had mixed-chimerism, progressing to full-donor-chimerism in 11 patients, after the interruption of the CSA therapy, and, in one patient, after DLI. Nine patients died, six from relapse or disease progression and three from transplantation-related complications (GVHD, infection or secondary malignancy). 14 month overall survival and disease free survival of 55% and 50%, respec¬tively, was observed."nConclusion: Our results confirm that NM-allo-SCT is safe and minimally toxic and is a potential new approach for a safer treatment of a large variety of hematologic diseases, especially in patients with AML and CML in remission.http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/4492.pdf&manuscript_id=4492 Hematopoietic stem cell transplantationAllogeneicNon-myeloablativeGraft vs Host Dis¬ease |
| spellingShingle | Keyhanian S Ghavamzadeh A Bahar B Alimoghaddam K Shamshiri AR Gholibeikian.S Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center International Journal of Hematology-Oncology and Stem Cell Research Hematopoietic stem cell transplantation Allogeneic Non-myeloablative Graft vs Host Dis¬ease |
| title | Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center |
| title_full | Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center |
| title_fullStr | Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center |
| title_full_unstemmed | Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center |
| title_short | Non-Myeloablative Stem Cell Transplantation in Hematologic Malig¬nancies: An Experience from the Hematology-Oncology and BMT Re¬search Center |
| title_sort | non myeloablative stem cell transplantation in hematologic malig¬nancies an experience from the hematology oncology and bmt re¬search center |
| topic | Hematopoietic stem cell transplantation Allogeneic Non-myeloablative Graft vs Host Dis¬ease |
| url | http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/4492.pdf&manuscript_id=4492 |
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