Reduced-intensity allogeneic hematopoietic stem cell transplantation for acute leukemias: 'What is the best recipe?'

A. A. Kassim, W. Chinratanalab, J. L.M. Ferrara, S. Mineishi

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

Reduced-intensity stem cell transplantation (RIST) has been shown to be a safe and useful alternative transplant method for patients including elderly and medically unfit patients. RIST conditioning regimens vary widely in the intensity of myeloablation, immunoablation, and antileukemia effects, and thus optimal regimen for each disease entity is yet to be determined. Most reports on RIST to date are small, single-institution experiences or retrospective studies with heterogeneous patient populations and primary diseases, complicating any direct comparison between studies. In acute myeloid leukemia (AML), moderate-intensity regimens may be effective, achieving 30-70% 1-year disease-free survival in various series, but minimal-intensity regimens are associated with high relapse rates. In acute lymphoblastic leukemia (ALL), not even moderate-intensity regimens are effective and most patients with advanced ALL relapse post transplant. Thus, the risk/ benefit ratios of graft-versus-host disease/graft-versus-leukemia effect differ among diseases. Larger, prospective, multi-center clinical trials are needed to determine the best use of RIST in hematologic malignancies.

Original languageEnglish (US)
Pages (from-to)565-574
Number of pages10
JournalBone Marrow Transplantation
Volume36
Issue number7
DOIs
StatePublished - Oct 1 2005

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Hematopoietic Stem Cell Transplantation
Stem Cell Transplantation
Leukemia
Transplants
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Transplantation Conditioning
Recurrence
Graft vs Host Disease
Hematologic Neoplasms
Acute Myeloid Leukemia
Disease-Free Survival
Retrospective Studies
Odds Ratio
Clinical Trials
Population

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

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title = "Reduced-intensity allogeneic hematopoietic stem cell transplantation for acute leukemias: 'What is the best recipe?'",
abstract = "Reduced-intensity stem cell transplantation (RIST) has been shown to be a safe and useful alternative transplant method for patients including elderly and medically unfit patients. RIST conditioning regimens vary widely in the intensity of myeloablation, immunoablation, and antileukemia effects, and thus optimal regimen for each disease entity is yet to be determined. Most reports on RIST to date are small, single-institution experiences or retrospective studies with heterogeneous patient populations and primary diseases, complicating any direct comparison between studies. In acute myeloid leukemia (AML), moderate-intensity regimens may be effective, achieving 30-70{\%} 1-year disease-free survival in various series, but minimal-intensity regimens are associated with high relapse rates. In acute lymphoblastic leukemia (ALL), not even moderate-intensity regimens are effective and most patients with advanced ALL relapse post transplant. Thus, the risk/ benefit ratios of graft-versus-host disease/graft-versus-leukemia effect differ among diseases. Larger, prospective, multi-center clinical trials are needed to determine the best use of RIST in hematologic malignancies.",
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Reduced-intensity allogeneic hematopoietic stem cell transplantation for acute leukemias : 'What is the best recipe?'. / Kassim, A. A.; Chinratanalab, W.; Ferrara, J. L.M.; Mineishi, S.

In: Bone Marrow Transplantation, Vol. 36, No. 7, 01.10.2005, p. 565-574.

Research output: Contribution to journalReview article

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AU - Kassim, A. A.

AU - Chinratanalab, W.

AU - Ferrara, J. L.M.

AU - Mineishi, S.

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AB - Reduced-intensity stem cell transplantation (RIST) has been shown to be a safe and useful alternative transplant method for patients including elderly and medically unfit patients. RIST conditioning regimens vary widely in the intensity of myeloablation, immunoablation, and antileukemia effects, and thus optimal regimen for each disease entity is yet to be determined. Most reports on RIST to date are small, single-institution experiences or retrospective studies with heterogeneous patient populations and primary diseases, complicating any direct comparison between studies. In acute myeloid leukemia (AML), moderate-intensity regimens may be effective, achieving 30-70% 1-year disease-free survival in various series, but minimal-intensity regimens are associated with high relapse rates. In acute lymphoblastic leukemia (ALL), not even moderate-intensity regimens are effective and most patients with advanced ALL relapse post transplant. Thus, the risk/ benefit ratios of graft-versus-host disease/graft-versus-leukemia effect differ among diseases. Larger, prospective, multi-center clinical trials are needed to determine the best use of RIST in hematologic malignancies.

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