Chonnam Med J.  2002 Mar;38(1):37-43.

Hematopoietic Stem Cell Transplantation Using Non-myeloablative Preparative Regimens

• Cho SH
• Lee IK
• Kim HJ

Abstract

Allogeneic hematopoietic transplantation is an effective therapy for a range of malignancies. Much of the benefits of transplantation results from graft-versus-malignancy effects mediated by donor immunocompetent cells. An alternative approach is to utilize less toxic, nonmyeloablative preparative regimens to achieve engraftment and graft-versus-malignancy effects. The object of this study was to assess the engraftment of allogeneic peripheral blood cells after purine analog-containing nonmyeloablative chemotherapy. Patients with advanced hematologic malignancies refractory to the conventional chemotherapy were enrolled in this study. All patients had an HLA-identical related donors. Five patients received fludarabine at 25 mg/m2/day for 5 days with cyclophosphamide at 60mg/kg/day for 2 days and one was treated by fludarabine at 30 mg/m2/day for 5 days with ara-c 2 g/m2/day for 4 days. Graft-versus-host disease (GVHD) was prevented by cyclosporine and mycophenolate mofetil. Treatment was well tolerated. Acute GVHD more than grade II occurred in three patients. Chimerism analysis of two patients showed that more than 90% the bone marrow cells were donor origin between 28 and 56 days postinfusion. Bone marrow cells of the two of the remaining four patients were consisted of more than 60% of donor cells between 28 and 56 days postinfusion. The purine analogcontaining nonmyeloablative regimens appeared to allow engraftment of HLA-compatible hematopoietic progenitor cells.

Keyword

Non-myeloablative allogeneic transplantation; Graft versus malignancy effect

MeSH Terms

Blood Cells
Bone Marrow Cells
Chimerism
Cyclophosphamide
Cyclosporine
Cytarabine
Drug Therapy
Graft vs Host Disease
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation*
Hematopoietic Stem Cells*
Humans
Tissue Donors
Cyclophosphamide
Cyclosporine
Cytarabine