A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence graft-versus-host disease

K. B. Miller, T. F. Roberts, G. Chan, D. P. Schenkein, D. Lawrence, K. Sprague, G. Gorgun, V. Relias, H. Grodman, A. Mahajan, F. M. Foss

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53 Scopus citations

Abstract

In all, 55 patients at high risk or ineligible for a conventional allogeneic hematopoietic stem cell transplant (HSCT) received a regimen consisting of extracorporeal photopheresis, pentostatin, and reduced dose total body irradiation. The median age was 49 years (18-70 years); 44 received a sibling and 11 an unrelated HSCT; 44% were over the age of 50 years and 31% had undergone a prior HSCT. Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and methotrexate. Full donor chimerism was documented in 98% by day + 100. The 1000-day nonrelapse mortality was 11%. The median follow-up is 502 days (154-1104 days). The 1- and 2-year overall survival (OS) and event-free survival (EFS) are 67, 58 and 55%, and 47%, respectively. Patients who had not received a prior HSCT or had less than three prior chemotherapy regimens had a 71% OS and 67% EFS at 1 year. Greater than grade II aGVHD developed in 9% and chronic GVHD (cGVHD) in 43%, and extensive in 12% and limited in 31%. Of the patients, 86% who engrafted had a disease response, 72% had complete and 14% partial responses. This novel reduced intensity preparative regimen was well tolerated and associated with a low incidence of transplant-related mortality and serious acute and cGVHD.

Original languageEnglish (US)
Pages (from-to)881-889
Number of pages9
JournalBone marrow transplantation
Volume33
Issue number9
DOIs
StatePublished - May 1 2004

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Keywords

  • Allogeneic
  • Pentostatin
  • Photopheresis
  • Reduced intensity

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Miller, K. B., Roberts, T. F., Chan, G., Schenkein, D. P., Lawrence, D., Sprague, K., Gorgun, G., Relias, V., Grodman, H., Mahajan, A., & Foss, F. M. (2004). A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence graft-versus-host disease. Bone marrow transplantation, 33(9), 881-889. https://doi.org/10.1038/sj.bmt.1704454