Low-intensity conditioning is sufficient to ensure engraftment in matched unrelated bone marrow transplantation

Nagler, Arnon; Aker, Memet; Or, Reuven; Naparstek, Elizabeth; Váradi, Gábor; Brautbar, Chaim; Slavin, Shimon

doi:10.1016/s0301-472x(00)00655-x

Cited by 91 publications

(76 citation statements)

References 42 publications

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“…[17][18][19] However, Bu/Flu/ ATG regimens, used in children with malignant and nonmalignant disorders, resulted in about 80% engraftment rate. 20,21 In a study that used fludarabine and busulfan targeted at 900 ng/ml for adults with CML and MDS, engraftment was achieved in all patients (26 out of 42 received unrelated donor mobilized blood stem cells).…”

Section: Discussionmentioning

confidence: 99%

Reduced intensity conditioning using intravenous busulfan, fludarabine and rabbit ATG for children with nonmalignant disorders and CML

Horn

Englert

et al. 2005

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Reduced intensity conditioning using intravenous busulfan, fludarabine and rabbit ATG for children with nonmalignant disorders and CML

Horn

Englert

et al. 2005

Bone Marrow Transplant

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“…RIC regimens were defined as previously reported. [24][25][26] Regimens used were fludarabine 150-180 mg/m 2 with either CY 60 mg/kg, BU 8 mg/kg or melphalan 80-140 mg/ m 2 with 4 Gy TBI. The prophylaxis regimens for GVHD were CYA or tacrolimus alone, CYA plus MTX or CYA plus mycophenolate mofetil.…”

Section: Transplantation Procedures and Definitionsmentioning

confidence: 99%

Expansion of donor-reactive host T cells in primary graft failure after allogeneic hematopoietic SCT following reduced-intensity conditioning

Koyama

Hashimoto

Nagafuji

et al. 2013

Bone Marrow Transplant

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Graft rejection remains a major obstacle in allogeneic hematopoietic SCT following reduced-intensity conditioning (RIC-SCT), particularly after cord blood transplantation (CBT). In a murine MHC-mismatched model of RIC-SCT, primary graft rejection was associated with activation and expansion of donor-reactive host T cells in peripheral blood and BM early after SCT. Donor-derived dendritic cells are at least partly involved in host T-cell activation. We then evaluated if such an expansion of host T cells could be associated with graft rejection after RIC-CBT. Expansion of residual host lymphocytes was observed in 4/7 patients with graft rejection at 3 weeks after CBT, but in none of the 17 patients who achieved engraftment. These results suggest the crucial role of residual host T cells after RIC-SCT in graft rejection and expansion of host T cells could be a marker of graft rejection. Development of more efficient T cell-suppressive conditioning regimens may be necessary in the context of RIC-SCT.

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“…The median time to myeloid engraftment was 14.5 days (2-45) (Figure 1a) and the median time for platelet engraftment was 21 days (6-170) (Figure 1b). UCB patients had a median time to myeloid engraftment of 18 days (2-45) and platelet engraftment of 31 days (6-170), while MFD patients' median time to myeloid engraftment was 14 days (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) and platelet engraftment was 11 days (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Hematologic Reconstitution Following Ri Allosctmentioning

confidence: 99%

“…[11][12][13][14][15][16][17] More recently, several investigators have demonstrated the ability to successfully induce complete donor chimerism following RI conditioning and AlloSCT from matched unrelated adult donors. [18][19][20][21] There is limited data regarding RI conditioning and AlloSCT in children and adolescents. 22 Myeloablative conditioning prior to SCT is limited in large part by a significant incidence of short-term toxicity and late effects.…”

mentioning

confidence: 99%

A pilot study of reduced intensity conditioning and allogeneic stem cell transplantation from unrelated cord blood and matched family donors in children and adolescent recipients

Toro

Satwani

Harrison

et al. 2004

Bone Marrow Transplant

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Summary:Reduced intensity (RI) allogeneic stem cell transplantation (AlloSCT) was initially demonstrated in adults following HLA-matched family and unrelated adult donor AlloSCT. There is little information about RI AlloSCT in children. We report results of a pilot study of RI AlloSCT in 21 recipients (p21 years). Age: median 13 (0.5-21) years, 8F:13M, 14 unrelated cord blood units (UCB) (10 4/6, 4 5/6), two related BM (6/6, 5/6), four related PBSC (2 6/6, 2 5/6), and one related BM þ PBSC (6/6). RI: fludarabine, busulfan (n ¼ 14); fludarabine, cyclophosphamide (n ¼ 4); fludarabine, melphalan (n ¼ 1); total body irradiation, fludarabine, cyclophosphamide (n ¼ 1); or fludarabine, cyclophosphamide, and etoposide (n ¼ 1). Graft-versus-host disease prophylaxis: FK506 0.03 mg/ kg/day and mycophenolate mofetil 15 mg/kg/q 12 h. UCB median nuc/kg and CD34/kg was 4.3 Â 10 7 /kg (0.9-10.8) and 1.9 Â 10 5 /kg (0.3-6.9), and related BM/PBSC median nuc/kg and CD34/kg was 8.3 Â 10 8 (4.7-18.9) and 5.0 Â 10 6 /kg (4.6-6.4). Maximal chimerism following unrelated cord blood transplantation, 100% Â 7, 98% Â 1, 95% Â 2, 55% Â 1, and 0% Â 3; related PBSC/BM, 100% Â 5, 65% Â 1, and 55% Â 1. Graft failure occurred in 5/21 (24%). In summary, RI AlloSCT in children is feasible and tolerable (p25% GF) and results in X85% of recipients initially achieving X50% donor chimerism.

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Low-intensity conditioning is sufficient to ensure engraftment in matched unrelated bone marrow transplantation

Cited by 91 publications

References 42 publications

Reduced intensity conditioning using intravenous busulfan, fludarabine and rabbit ATG for children with nonmalignant disorders and CML

Reduced intensity conditioning using intravenous busulfan, fludarabine and rabbit ATG for children with nonmalignant disorders and CML

Expansion of donor-reactive host T cells in primary graft failure after allogeneic hematopoietic SCT following reduced-intensity conditioning

A pilot study of reduced intensity conditioning and allogeneic stem cell transplantation from unrelated cord blood and matched family donors in children and adolescent recipients

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