Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen.

2.50
Hdl Handle:
http://hdl.handle.net/10541/81234
Title:
Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen.
Authors:
Chakraverty, Ronjon; Peggs, Karl S; Chopra, Rajesh; Milligan, Donald W; Kottaridis, Panagiotis D; Verfuerth, Stephanie; Geary, Johanne; Thuraisundaram, Dharsha; Branson, Kate; Chakrabarti, Suparno; Mahendra, Premini; Craddock, Charles; Parker, Anne; Hunter, Ann; Hale, Geoff; Waldmann, Herman; Williams, Catherine D; Yong, Kwee; Linch, David C; Goldstone, Anthony H; Mackinnon, Stephen
Abstract:
A nonmyeloablative conditioning regimen was investigated in 47 patients with hematological malignancy receiving allogeneic progenitor cells from matched, unrelated donors. The median patient age was 44 years. The majority of patients had high-risk features, including having failed a prior transplantation (29 individuals). Twenty of the transplants were mismatched for HLA class I and/or class II alleles. Recipient conditioning consisted of 20 mg CAMPATH-1H on days -8 to -4, 30 mg/m(2) fludarabine on days -7 to -3, and 140 mg/m(2) melphalan on day -2. Graft-versus-host disease (GVHD) prophylaxis was with cyclosporine A alone. Primary graft failure occurred in only 2 of 44 evaluable patients (4.5%). Chimerism studies in 34 patients indicated that the majority (85.3%) attained initial full donor chimerism. Only 3 patients developed grade III to IV acute GVHD, and no patients have yet developed chronic extensive GVHD. The estimated probability of nonrelapse mortality at day 100 was 14.9% (95% confidence interval [CI], 4.7%-25.1%). With a median follow-up of 344 days (range, 79-830), overall and progression-free survivals at 1 year were 75.5% (95% CI, 62.8%-88.2%) and 61.5% (95% CI, 46.1%-76.8%), respectively. In summary, a nonmyeloablative regimen incorporating in vivo CAMPATH-1H is effective in promoting durable engraftment in most patients and in reducing the risk of severe GVHD following matched unrelated donor transplantation.
Affiliation:
Department of Haematology, University College Hospital, 98 Chenies Mews, London WC1E 6HX, United Kingdom.
Citation:
Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen. 2002, 99 (3):1071-8 Blood
Journal:
Blood
Issue Date:
1-Feb-2002
URI:
http://hdl.handle.net/10541/81234
PubMed ID:
11807015
Type:
Article
Language:
en
ISSN:
0006-4971
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorChakraverty, Ronjon-
dc.contributor.authorPeggs, Karl S-
dc.contributor.authorChopra, Rajesh-
dc.contributor.authorMilligan, Donald W-
dc.contributor.authorKottaridis, Panagiotis D-
dc.contributor.authorVerfuerth, Stephanie-
dc.contributor.authorGeary, Johanne-
dc.contributor.authorThuraisundaram, Dharsha-
dc.contributor.authorBranson, Kate-
dc.contributor.authorChakrabarti, Suparno-
dc.contributor.authorMahendra, Premini-
dc.contributor.authorCraddock, Charles-
dc.contributor.authorParker, Anne-
dc.contributor.authorHunter, Ann-
dc.contributor.authorHale, Geoff-
dc.contributor.authorWaldmann, Herman-
dc.contributor.authorWilliams, Catherine D-
dc.contributor.authorYong, Kwee-
dc.contributor.authorLinch, David C-
dc.contributor.authorGoldstone, Anthony H-
dc.contributor.authorMackinnon, Stephen-
dc.date.accessioned2009-09-16T10:04:49Z-
dc.date.available2009-09-16T10:04:49Z-
dc.date.issued2002-02-01-
dc.identifier.citationLimiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen. 2002, 99 (3):1071-8 Blooden
dc.identifier.issn0006-4971-
dc.identifier.pmid11807015-
dc.identifier.urihttp://hdl.handle.net/10541/81234-
dc.description.abstractA nonmyeloablative conditioning regimen was investigated in 47 patients with hematological malignancy receiving allogeneic progenitor cells from matched, unrelated donors. The median patient age was 44 years. The majority of patients had high-risk features, including having failed a prior transplantation (29 individuals). Twenty of the transplants were mismatched for HLA class I and/or class II alleles. Recipient conditioning consisted of 20 mg CAMPATH-1H on days -8 to -4, 30 mg/m(2) fludarabine on days -7 to -3, and 140 mg/m(2) melphalan on day -2. Graft-versus-host disease (GVHD) prophylaxis was with cyclosporine A alone. Primary graft failure occurred in only 2 of 44 evaluable patients (4.5%). Chimerism studies in 34 patients indicated that the majority (85.3%) attained initial full donor chimerism. Only 3 patients developed grade III to IV acute GVHD, and no patients have yet developed chronic extensive GVHD. The estimated probability of nonrelapse mortality at day 100 was 14.9% (95% confidence interval [CI], 4.7%-25.1%). With a median follow-up of 344 days (range, 79-830), overall and progression-free survivals at 1 year were 75.5% (95% CI, 62.8%-88.2%) and 61.5% (95% CI, 46.1%-76.8%), respectively. In summary, a nonmyeloablative regimen incorporating in vivo CAMPATH-1H is effective in promoting durable engraftment in most patients and in reducing the risk of severe GVHD following matched unrelated donor transplantation.en
dc.language.isoenen
dc.subjectCancer Antibodiesen
dc.subjectHaematologic Canceren
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAntibodies, Monoclonal-
dc.subject.meshAntibodies, Neoplasm-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshFemale-
dc.subject.meshGraft Survival-
dc.subject.meshGraft vs Host Disease-
dc.subject.meshHematologic Neoplasms-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshInfection-
dc.subject.meshMale-
dc.subject.meshMelphalan-
dc.subject.meshMiddle Aged-
dc.subject.meshSurvival Analysis-
dc.subject.meshTissue Donors-
dc.subject.meshTransplantation Chimera-
dc.subject.meshTransplantation Conditioning-
dc.subject.meshTransplantation, Homologous-
dc.subject.meshTreatment Outcome-
dc.subject.meshVidarabine-
dc.titleLimiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen.en
dc.typeArticleen
dc.contributor.departmentDepartment of Haematology, University College Hospital, 98 Chenies Mews, London WC1E 6HX, United Kingdom.en
dc.identifier.journalBlooden

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