Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , DNA (Cytosine-5-)-Methyltransferases/genetics , Exons/genetics , Leukemia, Myeloid, Acute/mortality , Mutation/genetics , Aged , Aged, 80 and over , Cytarabine/administration & dosage , DNA Methyltransferase 3A , Daunorubicin/administration & dosage , Etoposide/administration & dosage , Female , Follow-Up Studies , Humans , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/genetics , Male , Middle Aged , Mitoxantrone/administration & dosage , Neoplasm Staging , Prognosis , Survival RateABSTRACT
Reduced-intensity conditioning (RIC) regimens in cord blood transplant (CBT) are increasingly utilized for older patients and those with comorbidities. However, the optimal conditioning regimen has not yet been established and remains a significant challenge of this therapeutic approach. Antithymocyte globulin (ATG) has been incorporated into conditioning regimens in order to decrease the risk of graft failure; however, use of ATG is often associated with infusion reactions and risk of post-transplant complications. We report the results of a non-ATG-containing RIC regimen, where patients received 2 Gy TBI unless they were considered to be at higher risk of graft failure, in which case they received 3 Gy of TBI. Thirty patients underwent CBT using this protocol for high-risk hematological malignancies. There was only one case of secondary and no cases of primary graft failure. At 1 year, estimates of non-relapse mortality, OS and PFS were 29%, 53% and 45%, respectively. The cumulative incidences of grade III-IV acute and chronic GVHD were 14% and 18%, respectively. In summary, the results of this study demonstrate that this non-ATG-containing conditioning regimen provides a low incidence of graft failure without increasing regimen-related toxicity.
Subject(s)
Antilymphocyte Serum , Cord Blood Stem Cell Transplantation , Hematologic Neoplasms/therapy , Immunologic Factors , Transplantation Conditioning , Whole-Body Irradiation , Acute Disease , Adult , Aged , Chronic Disease , Female , Graft Rejection/epidemiology , Graft Rejection/prevention & control , Graft vs Host Disease/epidemiology , Graft vs Host Disease/prevention & control , Hematologic Neoplasms/epidemiology , Humans , Incidence , Male , Middle AgedSubject(s)
Antibodies, Monoclonal/therapeutic use , Guillain-Barre Syndrome/drug therapy , Hematopoietic Stem Cell Transplantation/adverse effects , Immunologic Factors/therapeutic use , Antibodies, Monoclonal, Murine-Derived , Guillain-Barre Syndrome/immunology , Guillain-Barre Syndrome/virology , Herpesvirus 4, Human/drug effects , Humans , Male , Middle Aged , Rituximab , Transplantation, Homologous , Viremia/drug therapySubject(s)
Anemia, Aplastic/therapy , Bone Marrow Transplantation/adverse effects , Epstein-Barr Virus Infections/complications , Inappropriate ADH Syndrome/complications , Lymphoproliferative Disorders/etiology , Adult , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Murine-Derived , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Doxorubicin/administration & dosage , Female , Humans , Inappropriate ADH Syndrome/drug therapy , Lymphoproliferative Disorders/drug therapy , Rituximab , Transplantation, Homologous/adverse effectsSubject(s)
Antibodies, Monoclonal/therapeutic use , Bone Marrow Transplantation/adverse effects , Hemolytic-Uremic Syndrome/etiology , Hemolytic-Uremic Syndrome/therapy , Adult , Antibodies, Monoclonal, Murine-Derived , Hemolytic-Uremic Syndrome/physiopathology , Humans , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Rituximab , Transplantation, HomologousSubject(s)
Fungemia/microbiology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/microbiology , Mycoses/microbiology , Pichia/isolation & purification , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Female , Fungemia/drug therapy , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Middle Aged , Mycoses/drug therapySubject(s)
Antibodies, Monoclonal/administration & dosage , Antineoplastic Agents/administration & dosage , Lymphoma, Non-Hodgkin/drug therapy , Renal Dialysis/methods , Renal Insufficiency/drug therapy , Aged , Antibodies, Monoclonal, Murine-Derived , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fatal Outcome , Female , Humans , Lymphoma, Non-Hodgkin/complications , Male , Middle Aged , Remission Induction , Rituximab , Venous Thrombosis/complicationsABSTRACT
Peripheral blood progenitor cell (PBPC) harvests mobilized by granulocyte colony-stimulating factor (G-CSF) contain more CD34+ cells and provide more rapid engraftment than do bone marrow (BM) harvests. However, some reports have suggested a higher risk of chronic graft-versus-host disease (GVHD), possibly because such PBPC harvests contain approximately 10 times more T lymphocytes than do BM harvests. Some groups are attempting to combine the faster engraftment of PBPCs with the lower incidence of GVHD observed after BM transplantation by using G-CSF-primed BM conventionally harvested from iliac crests for allogenic BM transplantation. We report the results of a pilot study of 38 allogeneic transplants using G-CSF-stimulated BM from related donors, with a focus on the harvest composition, engraftment, and incidence of acute and chronic GVHDs.
