PMID- 19423725
OWN - NLM
STAT- MEDLINE
DCOM- 20090921
LR  - 20211020
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 114
IP  - 5
DP  - 2009 Jul 30
TI  - TLI and ATG conditioning with low risk of graft-versus-host disease retains 
      antitumor reactions after allogeneic hematopoietic cell transplantation from 
      related and unrelated donors.
PG  - 1099-109
LID - 10.1182/blood-2009-03-211441 [doi]
AB  - A hematopoietic cell transplantation regimen was adapted from a preclinical model 
      that used reduced-intensity conditioning (RIC) and protected against 
      graft-versus-host disease (GVHD) by skewing residual host T-cell subsets to favor 
      regulatory natural killer T cells. One hundred eleven patients with lymphoid (64) 
      and myeloid (47) malignancies received RIC using total lymphoid irradiation (TLI) 
      and antithymocyte globulin (ATG) followed by the infusion of granulocyte 
      colony-stimulating factor-mobilized grafts. Included were 34 patients at least 60 
      years of age, 32 patients at high risk of lymphoma relapse after disease 
      recurrence following prior autologous transplantation, and 51 patients at high 
      risk of developing GVHD due to lack of a fully human leukocyte antigen 
      (HLA)-matched related donor. Durable chimerism was achieved in 97% of patients. 
      Cumulative probabilities of acute GVHD (grades II-IV) were 2 and 10% of patients 
      receiving related and unrelated donor grafts. Nonrelapse mortality (NRM) at 1 
      year was less than 4%. Cumulative incidence of chronic GVHD was 27%. The 36-month 
      probability of overall and event-free survival was 60% and 40%, respectively. 
      Disease status at start of conditioning and the level of chimerism achieved after 
      transplantation significantly impacted clinical outcome. The high incidence of 
      sustained remission among patients with active disease at time of transplantation 
      suggests retained graft-versus-tumor reactions. Active trial registration 
      currently at clinicaltrials.gov under IDs of NCT00185640 and NCT00186615.
FAU - Kohrt, Holbrook E
AU  - Kohrt HE
AD  - Department of Medicine, Stanford University School of Medicine, CA 94305, USA.
FAU - Turnbull, Brit B
AU  - Turnbull BB
FAU - Heydari, Kartoosh
AU  - Heydari K
FAU - Shizuru, Judith A
AU  - Shizuru JA
FAU - Laport, Ginna G
AU  - Laport GG
FAU - Miklos, David B
AU  - Miklos DB
FAU - Johnston, Laura J
AU  - Johnston LJ
FAU - Arai, Sally
AU  - Arai S
FAU - Weng, Wen-Kai
AU  - Weng WK
FAU - Hoppe, Richard T
AU  - Hoppe RT
FAU - Lavori, Philip W
AU  - Lavori PW
FAU - Blume, Karl G
AU  - Blume KG
FAU - Negrin, Robert S
AU  - Negrin RS
FAU - Strober, Samuel
AU  - Strober S
FAU - Lowsky, Robert
AU  - Lowsky R
LA  - eng
SI  - ClinicalTrials.gov/NCT00185640
SI  - ClinicalTrials.gov/NCT00186615
GR  - P01 CA049605/CA/NCI NIH HHS/United States
GR  - P01 HL075462/HL/NHLBI NIH HHS/United States
GR  - P30 CA124435/CA/NCI NIH HHS/United States
GR  - 1P030CA124435-01/CA/NCI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20090507
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Anti-Infective Agents)
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (Immunosuppressive Agents)
RN  - 143011-72-7 (Granulocyte Colony-Stimulating Factor)
RN  - 83HN0GTJ6D (Cyclosporine)
RN  - HU9DX48N0T (Mycophenolic Acid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Infective Agents/therapeutic use
MH  - Antilymphocyte Serum/*administration & dosage
MH  - Cyclosporine/therapeutic use
MH  - Disease-Free Survival
MH  - Family
MH  - Female
MH  - Graft vs Host Disease/epidemiology/prevention & control
MH  - Granulocyte Colony-Stimulating Factor/therapeutic use
MH  - Hematologic Neoplasms/mortality/*surgery
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - *Living Donors
MH  - *Lymphatic Irradiation
MH  - Male
MH  - Middle Aged
MH  - Mycophenolic Acid/analogs & derivatives/therapeutic use
MH  - Premedication
MH  - Risk
MH  - T-Lymphocytes/*immunology
MH  - Transplantation Conditioning/*methods
MH  - Transplantation, Homologous
MH  - Treatment Outcome
PMC - PMC2721787
EDAT- 2009/05/09 09:00
MHDA- 2009/09/22 06:00
PMCR- 2010/07/30
CRDT- 2009/05/09 09:00
PHST- 2009/05/09 09:00 [entrez]
PHST- 2009/05/09 09:00 [pubmed]
PHST- 2009/09/22 06:00 [medline]
PHST- 2010/07/30 00:00 [pmc-release]
AID - S0006-4971(20)42183-4 [pii]
AID - 2009/211441 [pii]
AID - 10.1182/blood-2009-03-211441 [doi]
PST - ppublish
SO  - Blood. 2009 Jul 30;114(5):1099-109. doi: 10.1182/blood-2009-03-211441. Epub 2009 
      May 7.