PMID- 12838275
OWN - NLM
STAT- MEDLINE
DCOM- 20040324
LR  - 20211203
IS  - 0268-3369 (Print)
IS  - 0268-3369 (Linking)
VI  - 32
IP  - 2
DP  - 2003 Jul
TI  - Use of a reduced-intensity conditioning regimen for allogeneic transplantation in 
      patients with chronic myeloid leukemia.
PG  - 125-9
AB  - Reduced-intensity conditioning that harnesses the potential of a 
      graft-versus-tumor (GVT) effect has been proposed as an alternative to 
      conventional myeloablative allogeneic stem cell transplantation. The primary aim 
      is engraftment and this can be achieved with minimal immunosuppression. In this 
      report, we describe the use of such regimens for CML in 17 patients who received 
      human leukocyte antigen (HLA)-matched sibling allografts. Conditioning was with 
      fludarabine, antithymocyte globulin (ATG) and busulfan for the first 11 patients, 
      whereas fludarabine, busulfan and TBI were used for the remaining six patients. 
      Engraftment was prompt in most of the cases. Complications and need for 
      supportive therapy in the immediate post-transplant period were reduced 
      drastically. Only two patients (both in the TBI group) died within the first 100 
      days. Acute graft-versus-host disease (GVHD) grade II-IV was seen in seven 
      patients. Complications occurred later on. Chronic GVHD was observed in 11/17 
      patients. Lung infection and GVHD were the major killers. In surviving patients, 
      after a median follow-up of 30 months (range 37-21 months), 6/17 (35.3%) are 
      alive. Five are disease free and one patient is still in relapse even after a 
      second donor lymphocyte infusion. Total treatment time and cost were more than 
      with conventional transplants. We conclude that reduced-intensity transplantation 
      still requires further refinement.
FAU - Das, M
AU  - Das M
AD  - Bone Marrow Transplant Unit, Department of Medical Oncology, Tata Memorial 
      Hospital, Mumbai 400012, India.
FAU - Saikia, T K
AU  - Saikia TK
FAU - Advani, S H
AU  - Advani SH
FAU - Parikh, P M
AU  - Parikh PM
FAU - Tawde, S
AU  - Tawde S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - England
TA  - Bone Marrow Transplant
JT  - Bone marrow transplantation
JID - 8702459
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/adverse effects/*methods/mortality
MH  - Hospitalization
MH  - Humans
MH  - Immunosuppression Therapy/adverse effects/economics/methods
MH  - Immunosuppressive Agents/therapeutic use
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications/mortality/*therapy
MH  - Male
MH  - Radiation Dosage
MH  - Survival Analysis
MH  - Transplantation Conditioning/adverse effects/*methods
MH  - Transplantation, Homologous
MH  - Treatment Outcome
MH  - Whole-Body Irradiation
EDAT- 2003/07/03 05:00
MHDA- 2004/03/25 05:00
CRDT- 2003/07/03 05:00
PHST- 2003/07/03 05:00 [pubmed]
PHST- 2004/03/25 05:00 [medline]
PHST- 2003/07/03 05:00 [entrez]
AID - 1704107 [pii]
AID - 10.1038/sj.bmt.1704107 [doi]
PST - ppublish
SO  - Bone Marrow Transplant. 2003 Jul;32(2):125-9. doi: 10.1038/sj.bmt.1704107.