Anti-T-lymphocyte globulin based non-myeloablative stem cell transplantation followed by HLA-identical donor lymphocyte infusion for hematologic malignancies / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 70-73, 2003.
Article
in English
| WPRIM
| ID: wpr-356866
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the application of anti-T-lymphocyte globulin (ATG) based nonmyeloablative but profoundly immunosuppressive regimens followed by donor lymphocyte infusion (DLI) for the treatment of hematologic malignancies.</p><p><b>METHODS</b>The protocol was designed to minimize the intensity of the conditioning regimen to the range of nonmyeloablative therapies based on ATG with low-dose busulfan (Bu) and Cytoxan (CTX) (15 - 19.5 mg/kg, 8 mg/kg and 80 mg/kg, respectively). The patients received the first lymphocytic infusion from HLA-identical sibling donors on days 28 - 30 after transplant, and the first T cell dosage of 10(6)/kg followed by the escalated dosage in the range of (0.5 - 1.5) x 10(8)/kg. The total number of procedures were performed at a median of 4.2 procedures (range of 2 - 8 procedures).</p><p><b>RESULTS</b>Engraftment was documented in all six patients in the form of donor-recipient hematopoietic cells mixed chimera at early-stage posttransplant, which was converted gradually into complete chimera by DLI in four patients. Graft-versus-host disease (GVHD) developed in three of six cases, only one of which was severe. To date, four patients are disease free and alive.</p><p><b>CONCLUSIONS</b>Allogeneic donor stem cell engraftment into host can be achieved by nonmyeloablative conditioning regimen based on ATG. Transient mixed donor-recipient hematopoietic cell mixed with chimeras may be successfully converted into complete chimerism by DLI posttransplant. GVHD remains major clinical concern in our study.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Therapeutics
/
Histocompatibility Testing
/
T-Lymphocytes
/
Transplantation Chimera
/
Lymphocyte Transfusion
/
Hematopoietic Stem Cell Transplantation
/
Hematologic Neoplasms
/
Transplantation Conditioning
/
Therapeutic Uses
/
Allergy and Immunology
Type of study:
Practice guideline
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Chinese Medical Journal
Year:
2003
Type:
Article
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