TITLE

Safety and outcome after fludarabine-thiotepa-TBI conditioning for allogeneic transplantation: a prospective study of 30 patients with hematologic malignancies

AUTHOR(S)
van Besien, K; Devine, S; Wickrema, A; Jessop, E; Amin, K; Yassine, M; Maynard, V; Stock, W; Peace, D; Ravandi, F; Chen, Y-H; Cheung, T; Vijayakumar, S; Hoffman, R; Sosman, J
PUB. DATE
July 2003
SOURCE
Bone Marrow Transplantation;Jul2003, Vol. 32 Issue 1, p9
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Summary:Fludarabine, thiotepa and total body irradiation (TBI) has been used as conditioning in haplo-identical transplantation. We studied this conditioning regimen in adults undergoing matched sibling transplantation and alternative donor transplantation. A total of 30 consecutive patients underwent matched related, haplo-identical related or matched unrelated donor transplantation with fludarabine, thiotepa and TBI conditioning. All but four had advanced hematologic malignancies. For haplo-identical transplant, ATG was added to the regimen. All patients received peripheral blood stem cells; these were T-cell depleted for 2-antigen or 3-antigen mismatched related transplantation. Additional graft-versus-host disease prophylaxis consisted of tacrolimus and mini-methotrexate. One recipient of haplo-identical transplant failed to engraft; all other evaluable patients had prompt engraftment. Four patients died of regimen-related toxicity. In all, 14 additional patients died of regimen-related causes including four from failure to thrive with persistent thrombocytopenia and four from delayed pulmonary toxicity. Six patients relapsed. Progression-free survival at 12 months was 47% (90% CI: 25-69%) for recipients of HLA-identical sibling transplants and 30% (90% CI: 14-46%) for all patients. Five of six long-term survivors have extensive chronic GVHD. As a result of the delayed complications and a relatively high recurrence rate, we abandoned this regimen.Bone Marrow Transplantation (2003) 32, 9-13. doi:10.1038/sj.bmt.1704088
ACCESSION #
10068326

 

Related Articles

  • Reliability of a pretransplant i.v. BU test dose performed 2 weeks before myeloablative FluBu conditioning regimen. Beri, R.; Chunduri, S.; Sweiss, K.; Peace, D. J.; Mactal-Haaf, C.; Dobogai, L. C.; Shord, S.; Quigley, J. G.; Chen, Y. H.; Mahmud, N.; Rondelli, D. // Bone Marrow Transplantation;Feb2010, Vol. 45 Issue 2, p249 

    A pretransplant test dose of i.v. BU was previously used in pediatric patients undergoing a reduced-intensity allogeneic hematopoietic SCT (HSCT). Here, we used a BU test dose in 23 adult patients who were not pancytopenic and underwent a myeloablative allogeneic HSCT prepared with fludarabine...

  • Protective Conditioning for Acute Graft-versus-Host Disease. Lowsky, Robert; Takahashi, Tsuyoshi; Liu, Yin Ping; Dejbakhsh-Jones, Sussan; Grumet, F. Carl; Shizuru, Judith A.; Laport, Ginna G.; Stockerl-Goldstein, Keith E.; Johnston, Laura J.; Hoppe, Richard T.; Bloch, Daniel A.; Blume, Karl G.; Negrin, Robert S.; Strober, Samuel // New England Journal of Medicine;9/29/2005, Vol. 353 Issue 13, p1321 

    Background: Conditioning with total lymphoid irradiation plus antithymocyte serum protects mice against acute graft-versus-host disease (GVHD) after hematopoietic-cell transplantation. We tested this strategy in humans. Methods: Thirty-seven patients with lymphoid malignant diseases or acute...

  • Peri-engraftment clinical abnormalities following allogeneic hematopoietic cell transplantation: a retrospective review of 216 patients. Choi, S-J; Lee, K-H; Lee, J-H; Kim, S; Seol, M; Lee, Y-S; Kim, W-K; Park, C-J; Chi, H-S; Lee, J-S // Bone Marrow Transplantation;Oct2003, Vol. 32 Issue 8, p809 

    Summary:To evaluate the significance of clinical abnormalities occurring during the peri-engraftment period following allogeneic hematopoietic cell transplantation (HCT), we retrospectively analyzed the data of 216 allogeneic HCT recipients. The most frequently observed peri-engraftment clinical...

  • Bronchiolitis obliterans following pediatric allogeneic hematopoietic stem cell transplantation. Duncan, C. N.; Buonanno, M. R.; Barry, E. V.; Myers, K.; Peritz, D.; Lehmann, L. // Bone Marrow Transplantation;Jun2008, Vol. 41 Issue 11, p971 

    Bronchiolitis obliterans (BrOb) is a well-recognized complication of allogeneic hematopoietic stem cell transplantation (HSCT). It is associated with substantial morbidity and mortality in adult patients. However, the incidence and morbidity of this complication have not been well described in...

  • Reduced respiratory and skeletal muscle strength in survivors of sibling or unrelated donor hematopoietic stem cell transplantation. Kovalszki, A.; Schumaker, G. L.; Klein, A.; Terrin, N.; White, A. C. // Bone Marrow Transplantation;Jun2008, Vol. 41 Issue 11, p965 

    We performed a retrospective analysis of muscle strength testing obtained following sibling or unrelated donor hematopoietic stem cell transplant (HSCT) between 1 January 1999 and 31 December 2003 in a cohort of 44 subjects at Tufts-New England Medical Center. Maximal inspiratory pressure...

  • Getting a Handle on Graft-versus-Host Disease. Parkman, Robertson // New England Journal of Medicine;2/5/2004, Vol. 350 Issue 6, p614 

    Discusses the current issues of graft-versus-host disease. Center dichtomy of allogenic hematopoietic stem-cell transplantation for neoplastic diseases; Chief benefit of immune responses initiated by donor-derived cells; Reasons for the immune response; Reason why the graft-versus-tumor effect...

  • Posaconazole demonstrates efficacy for prophylaxis of fungal infections in certain patients.  // Formulary;Mar2007, Vol. 42 Issue 3, p184 

    The article reports on the efficacy of posaconazole for treating patients with prophylaxis of fungal infections. This has been demonstrated by two randomized and controlled trials indicating that posaconazole considered a primary option for these patients with severe graft versus host disease...

  • Update on Graft versus Host Disease. Gilliam, Anita C. // Journal of Investigative Dermatology;Aug2004, Vol. 123 Issue 2, p251 

    Entirely new concepts about graft versus malignancy reactions have come from data collected over years of experience with transplantation in humans and in valuable mouse models. However, graft versus host disease (GVHD) continues to be a major complication of hematopoietic cell transplantation,...

  • Poikilodermia jako objaw choroby przeszczep przeciw gospodarzowi u pacjenta po przeszczepie szpiku kostnego z powodu przewlekÅ‚ej biaÅ‚aczki szpikowej -- opis przypadku. Rosińska, Anna; Zawirska, Agnieszka; Grzeszczak, Iwona; Adamski, Zygmunt // Clinical Dermatology / Dermatologia Kliniczna;2007, Vol. 9 Issue 1, p35 

    Graft versus host disease (GVHD) is one of the most common complications observed after bone marrow and inner organs transplantations or after transfusions of blood and it's products. GVHD is caused by immunocompetent lymphocytes contained in the transplanted tissue, due to ability of...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics