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, Gullu Gorgun, V. Relias, H. Grodman, A. Mahajan, F. M. Foss

Research output: Contribution to journalArticle

53 Citations (Scopus)

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 2004
Externally publishedYes

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Hematopoietic Stem Cell Transplantation
Graft vs Host Disease
Hematopoietic Stem Cells
Transplants
Incidence
Disease-Free Survival
Photopheresis
Pentostatin
Chimerism
Survival
Mortality
Whole-Body Irradiation
Methotrexate
Cyclosporine
Siblings
Tissue Donors
Drug Therapy

Keywords

  • Allogeneic
  • Pentostatin
  • Photopheresis
  • Reduced intensity

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence graft-versus-host disease. / Miller, K. B.; Roberts, T. F.; Chan, G.; Schenkein, D. P.; Lawrence, D.; Sprague, K.; Gorgun, Gullu; Relias, V.; Grodman, H.; Mahajan, A.; Foss, F. M.

In: Bone Marrow Transplantation, Vol. 33, No. 9, 05.2004, p. 881-889.

Research output: Contribution to journalArticle

Miller, KB, Roberts, TF, Chan, G, Schenkein, DP, Lawrence, D, Sprague, K, Gorgun, G, Relias, V, Grodman, H, Mahajan, A & Foss, FM 2004, 'A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence graft-versus-host disease', Bone Marrow Transplantation, vol. 33, no. 9, pp. 881-889. https://doi.org/10.1038/sj.bmt.1704454
Miller, K. B. ; Roberts, T. F. ; Chan, G. ; Schenkein, D. P. ; Lawrence, D. ; Sprague, K. ; Gorgun, Gullu ; Relias, V. ; Grodman, H. ; Mahajan, A. ; Foss, F. M. / A novel reduced intensity regimen for allogeneic hematopoietic stem cell transplantation associated with a reduced incidence graft-versus-host disease. In: Bone Marrow Transplantation. 2004 ; Vol. 33, No. 9. pp. 881-889.
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