Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin
Preparative regimens without total body irradiation (TBI) have been reported for alternative donor hemopoietic stem cell transplants (HSCT). Between 7 September 1994 and 7 June 1999 48 patients with advanced hematologic malignancies were conditioned with thiotepa (THIO) 15 mg/kg, cyclophosphamide (C...
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2000-12, Vol.26 (12), p.1305-1311 |
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| creator | LAMPARELLI, T VAN LINT, M. T DOMINIETTO, A DI GRAZIA, C BRUNO, B SESSAREGO, M CASARINO, L VERDIANI, S BACIGALUPO, A GUALANDI, F RAIOLA, A. M BARBANTI, M SACCHI, N FICAI, G GHINATTI, C BREGANTE, S BERISSO, G |
| description | Preparative regimens without total body irradiation (TBI) have been reported for alternative donor hemopoietic stem cell transplants (HSCT). Between 7 September 1994 and 7 June 1999 48 patients with advanced hematologic malignancies were conditioned with thiotepa (THIO) 15 mg/kg, cyclophosphamide (CY) 150 mg/kg and antithymocyte globulin (ATG). Donors were HLA mismatched family members (1-2 antigens) (FAM) (n = 24, median age 31 years) or HLA matched unrelated donors (UD) (n = 24, median age 34 years). GVHD prophylaxis was cyclosporine and methotrexate. Stem cell source was peripheral blood (n = 8) or bone marrow (n = 40). Hematologic recovery was seen in 42/46 (91%) evaluable patients and complete chimerism in 31/37 patients (85%). Acute GVHD grades III-IV were seen in 10/46 patients surviving 10 days (21%) and extensive chronic GVHD in 2/36 patients surviving 100 days (5%). Twenty-six patients died (54%), eight of recurrent disease (17%) and 18 of transplant-related complications (37%): main causes of TRM were GVHD (15%), infections (15%) and graft failure (4%). Twenty-two patients (46%) survive with a median follow-up of 877 days (287-1840). The actuarial 3-year survival is 49% for FAM and 42% for UD transplants. Results obtained with this regimen in unrelated grafts for advanced CML (n = 15) were not significantly different when compared to 21 concurrent UD grafts for advanced CML prepared with CY-TBI. In conclusion, the combination of THIO-CY-ATG allows engraftment of alternative donor hemopoietic stem cells. Results are similar when using unrelated matched donors or partially mismatched family donors, and not significantly different when compared to patients conditioned with CY-TBI. |
| doi_str_mv | 10.1038/sj.bmt.1702719 |
| format | Article |
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T ; DOMINIETTO, A ; DI GRAZIA, C ; BRUNO, B ; SESSAREGO, M ; CASARINO, L ; VERDIANI, S ; BACIGALUPO, A ; GUALANDI, F ; RAIOLA, A. M ; BARBANTI, M ; SACCHI, N ; FICAI, G ; GHINATTI, C ; BREGANTE, S ; BERISSO, G</creator><creatorcontrib>LAMPARELLI, T ; VAN LINT, M. T ; DOMINIETTO, A ; DI GRAZIA, C ; BRUNO, B ; SESSAREGO, M ; CASARINO, L ; VERDIANI, S ; BACIGALUPO, A ; GUALANDI, F ; RAIOLA, A. M ; BARBANTI, M ; SACCHI, N ; FICAI, G ; GHINATTI, C ; BREGANTE, S ; BERISSO, G</creatorcontrib><description>Preparative regimens without total body irradiation (TBI) have been reported for alternative donor hemopoietic stem cell transplants (HSCT). Between 7 September 1994 and 7 June 1999 48 patients with advanced hematologic malignancies were conditioned with thiotepa (THIO) 15 mg/kg, cyclophosphamide (CY) 150 mg/kg and antithymocyte globulin (ATG). Donors were HLA mismatched family members (1-2 antigens) (FAM) (n = 24, median age 31 years) or HLA matched unrelated donors (UD) (n = 24, median age 34 years). GVHD prophylaxis was cyclosporine and methotrexate. Stem cell source was peripheral blood (n = 8) or bone marrow (n = 40). Hematologic recovery was seen in 42/46 (91%) evaluable patients and complete chimerism in 31/37 patients (85%). Acute GVHD grades III-IV were seen in 10/46 patients surviving 10 days (21%) and extensive chronic GVHD in 2/36 patients surviving 100 days (5%). Twenty-six patients died (54%), eight of recurrent disease (17%) and 18 of transplant-related complications (37%): main causes of TRM were GVHD (15%), infections (15%) and graft failure (4%). Twenty-two patients (46%) survive with a median follow-up of 877 days (287-1840). The actuarial 3-year survival is 49% for FAM and 42% for UD transplants. Results obtained with this regimen in unrelated grafts for advanced CML (n = 15) were not significantly different when compared to 21 concurrent UD grafts for advanced CML prepared with CY-TBI. In conclusion, the combination of THIO-CY-ATG allows engraftment of alternative donor hemopoietic stem cells. Results are similar when using unrelated matched donors or partially mismatched family donors, and not significantly different when compared to patients conditioned with CY-TBI.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1702719</identifier><identifier>PMID: 11223970</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject><![CDATA[Actuarial Analysis ; Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Antigens ; Antilymphocyte serum ; Antilymphocyte Serum - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Biological and medical sciences ; Blood cancer ; Bone marrow ; Bone marrow transplantation ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Chimerism ; Complications ; Cyclophosphamide ; Cyclophosphamide - administration & dosage ; Cyclosporins ; Donors ; Engraftment ; Fatalities ; Female ; Globulins ; Graft rejection ; Graft Survival ; Graft vs Host Disease ; Graft-versus-host reaction ; Grafting ; Grafts ; Hematologic Neoplasms - drug therapy ; Hematologic Neoplasms - mortality ; Hematologic Neoplasms - therapy ; Hematopoietic Stem Cell Transplantation - methods ; Hematopoietic Stem Cell Transplantation - mortality ; Histocompatibility - drug effects ; Histocompatibility antigen HLA ; Humans ; Immunosuppressive Agents - administration & dosage ; Irradiation ; Male ; Medical sciences ; Methotrexate ; Middle Aged ; Peripheral blood ; Prophylaxis ; Radiation ; Stem cell transplantation ; Stem cells ; Survival ; Survival Rate ; thiotepa ; Thiotepa - administration & dosage ; Thymocytes ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation Conditioning - methods ; Transplantation, Homologous - methods ; Transplantation, Homologous - mortality ; Transplants ; Transplants & implants ; Treatment Outcome]]></subject><ispartof>Bone marrow transplantation (Basingstoke), 2000-12, Vol.26 (12), p.1305-1311</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Dec 2000</rights><rights>Macmillan Publishers Limited 2000.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-90177cf2d4d8e23a242835843a3777057af946c05d9576ff1017830f6b51ccd53</citedby><cites>FETCH-LOGICAL-c407t-90177cf2d4d8e23a242835843a3777057af946c05d9576ff1017830f6b51ccd53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=899350$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11223970$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LAMPARELLI, T</creatorcontrib><creatorcontrib>VAN LINT, M. T</creatorcontrib><creatorcontrib>DOMINIETTO, A</creatorcontrib><creatorcontrib>DI GRAZIA, C</creatorcontrib><creatorcontrib>BRUNO, B</creatorcontrib><creatorcontrib>SESSAREGO, M</creatorcontrib><creatorcontrib>CASARINO, L</creatorcontrib><creatorcontrib>VERDIANI, S</creatorcontrib><creatorcontrib>BACIGALUPO, A</creatorcontrib><creatorcontrib>GUALANDI, F</creatorcontrib><creatorcontrib>RAIOLA, A. M</creatorcontrib><creatorcontrib>BARBANTI, M</creatorcontrib><creatorcontrib>SACCHI, N</creatorcontrib><creatorcontrib>FICAI, G</creatorcontrib><creatorcontrib>GHINATTI, C</creatorcontrib><creatorcontrib>BREGANTE, S</creatorcontrib><creatorcontrib>BERISSO, G</creatorcontrib><title>Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>Preparative regimens without total body irradiation (TBI) have been reported for alternative donor hemopoietic stem cell transplants (HSCT). Between 7 September 1994 and 7 June 1999 48 patients with advanced hematologic malignancies were conditioned with thiotepa (THIO) 15 mg/kg, cyclophosphamide (CY) 150 mg/kg and antithymocyte globulin (ATG). Donors were HLA mismatched family members (1-2 antigens) (FAM) (n = 24, median age 31 years) or HLA matched unrelated donors (UD) (n = 24, median age 34 years). GVHD prophylaxis was cyclosporine and methotrexate. Stem cell source was peripheral blood (n = 8) or bone marrow (n = 40). Hematologic recovery was seen in 42/46 (91%) evaluable patients and complete chimerism in 31/37 patients (85%). Acute GVHD grades III-IV were seen in 10/46 patients surviving 10 days (21%) and extensive chronic GVHD in 2/36 patients surviving 100 days (5%). Twenty-six patients died (54%), eight of recurrent disease (17%) and 18 of transplant-related complications (37%): main causes of TRM were GVHD (15%), infections (15%) and graft failure (4%). Twenty-two patients (46%) survive with a median follow-up of 877 days (287-1840). The actuarial 3-year survival is 49% for FAM and 42% for UD transplants. Results obtained with this regimen in unrelated grafts for advanced CML (n = 15) were not significantly different when compared to 21 concurrent UD grafts for advanced CML prepared with CY-TBI. In conclusion, the combination of THIO-CY-ATG allows engraftment of alternative donor hemopoietic stem cells. Results are similar when using unrelated matched donors or partially mismatched family donors, and not significantly different when compared to patients conditioned with CY-TBI.</description><subject>Actuarial Analysis</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Antigens</subject><subject>Antilymphocyte serum</subject><subject>Antilymphocyte Serum - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>Blood cancer</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Chimerism</subject><subject>Complications</subject><subject>Cyclophosphamide</subject><subject>Cyclophosphamide - administration & dosage</subject><subject>Cyclosporins</subject><subject>Donors</subject><subject>Engraftment</subject><subject>Fatalities</subject><subject>Female</subject><subject>Globulins</subject><subject>Graft rejection</subject><subject>Graft Survival</subject><subject>Graft vs Host Disease</subject><subject>Graft-versus-host reaction</subject><subject>Grafting</subject><subject>Grafts</subject><subject>Hematologic Neoplasms - drug therapy</subject><subject>Hematologic Neoplasms - mortality</subject><subject>Hematologic Neoplasms - therapy</subject><subject>Hematopoietic Stem Cell Transplantation - methods</subject><subject>Hematopoietic Stem Cell Transplantation - mortality</subject><subject>Histocompatibility - drug effects</subject><subject>Histocompatibility antigen HLA</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Irradiation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methotrexate</subject><subject>Middle Aged</subject><subject>Peripheral blood</subject><subject>Prophylaxis</subject><subject>Radiation</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>thiotepa</subject><subject>Thiotepa - administration & dosage</subject><subject>Thymocytes</subject><subject>Transfusions. 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T ; DOMINIETTO, A ; DI GRAZIA, C ; BRUNO, B ; SESSAREGO, M ; CASARINO, L ; VERDIANI, S ; BACIGALUPO, A ; GUALANDI, F ; RAIOLA, A. M ; BARBANTI, M ; SACCHI, N ; FICAI, G ; GHINATTI, C ; BREGANTE, S ; BERISSO, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-90177cf2d4d8e23a242835843a3777057af946c05d9576ff1017830f6b51ccd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Actuarial Analysis</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Antigens</topic><topic>Antilymphocyte serum</topic><topic>Antilymphocyte Serum - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>Blood cancer</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Chimerism</topic><topic>Complications</topic><topic>Cyclophosphamide</topic><topic>Cyclophosphamide - administration & dosage</topic><topic>Cyclosporins</topic><topic>Donors</topic><topic>Engraftment</topic><topic>Fatalities</topic><topic>Female</topic><topic>Globulins</topic><topic>Graft rejection</topic><topic>Graft Survival</topic><topic>Graft vs Host Disease</topic><topic>Graft-versus-host reaction</topic><topic>Grafting</topic><topic>Grafts</topic><topic>Hematologic Neoplasms - drug therapy</topic><topic>Hematologic Neoplasms - mortality</topic><topic>Hematologic Neoplasms - therapy</topic><topic>Hematopoietic Stem Cell Transplantation - methods</topic><topic>Hematopoietic Stem Cell Transplantation - mortality</topic><topic>Histocompatibility - drug effects</topic><topic>Histocompatibility antigen HLA</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Irradiation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methotrexate</topic><topic>Middle Aged</topic><topic>Peripheral blood</topic><topic>Prophylaxis</topic><topic>Radiation</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>thiotepa</topic><topic>Thiotepa - administration & dosage</topic><topic>Thymocytes</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation</topic><topic>Transplantation Conditioning - methods</topic><topic>Transplantation, Homologous - methods</topic><topic>Transplantation, Homologous - mortality</topic><topic>Transplants</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LAMPARELLI, T</creatorcontrib><creatorcontrib>VAN LINT, M. T</creatorcontrib><creatorcontrib>DOMINIETTO, A</creatorcontrib><creatorcontrib>DI GRAZIA, C</creatorcontrib><creatorcontrib>BRUNO, B</creatorcontrib><creatorcontrib>SESSAREGO, M</creatorcontrib><creatorcontrib>CASARINO, L</creatorcontrib><creatorcontrib>VERDIANI, S</creatorcontrib><creatorcontrib>BACIGALUPO, A</creatorcontrib><creatorcontrib>GUALANDI, F</creatorcontrib><creatorcontrib>RAIOLA, A. 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T</au><au>DOMINIETTO, A</au><au>DI GRAZIA, C</au><au>BRUNO, B</au><au>SESSAREGO, M</au><au>CASARINO, L</au><au>VERDIANI, S</au><au>BACIGALUPO, A</au><au>GUALANDI, F</au><au>RAIOLA, A. M</au><au>BARBANTI, M</au><au>SACCHI, N</au><au>FICAI, G</au><au>GHINATTI, C</au><au>BREGANTE, S</au><au>BERISSO, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>2000-12-01</date><risdate>2000</risdate><volume>26</volume><issue>12</issue><spage>1305</spage><epage>1311</epage><pages>1305-1311</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>Preparative regimens without total body irradiation (TBI) have been reported for alternative donor hemopoietic stem cell transplants (HSCT). Between 7 September 1994 and 7 June 1999 48 patients with advanced hematologic malignancies were conditioned with thiotepa (THIO) 15 mg/kg, cyclophosphamide (CY) 150 mg/kg and antithymocyte globulin (ATG). Donors were HLA mismatched family members (1-2 antigens) (FAM) (n = 24, median age 31 years) or HLA matched unrelated donors (UD) (n = 24, median age 34 years). GVHD prophylaxis was cyclosporine and methotrexate. Stem cell source was peripheral blood (n = 8) or bone marrow (n = 40). Hematologic recovery was seen in 42/46 (91%) evaluable patients and complete chimerism in 31/37 patients (85%). Acute GVHD grades III-IV were seen in 10/46 patients surviving 10 days (21%) and extensive chronic GVHD in 2/36 patients surviving 100 days (5%). Twenty-six patients died (54%), eight of recurrent disease (17%) and 18 of transplant-related complications (37%): main causes of TRM were GVHD (15%), infections (15%) and graft failure (4%). Twenty-two patients (46%) survive with a median follow-up of 877 days (287-1840). The actuarial 3-year survival is 49% for FAM and 42% for UD transplants. Results obtained with this regimen in unrelated grafts for advanced CML (n = 15) were not significantly different when compared to 21 concurrent UD grafts for advanced CML prepared with CY-TBI. In conclusion, the combination of THIO-CY-ATG allows engraftment of alternative donor hemopoietic stem cells. Results are similar when using unrelated matched donors or partially mismatched family donors, and not significantly different when compared to patients conditioned with CY-TBI.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>11223970</pmid><doi>10.1038/sj.bmt.1702719</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0268-3369 |
| ispartof | Bone marrow transplantation (Basingstoke), 2000-12, Vol.26 (12), p.1305-1311 |
| issn | 0268-3369 1476-5365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_17840251 |
| source | MEDLINE; Nature; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Actuarial Analysis Adolescent Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Antigens Antilymphocyte serum Antilymphocyte Serum - administration & dosage Antineoplastic Combined Chemotherapy Protocols - administration & dosage Biological and medical sciences Blood cancer Bone marrow Bone marrow transplantation Bone marrow, stem cells transplantation. Graft versus host reaction Chimerism Complications Cyclophosphamide Cyclophosphamide - administration & dosage Cyclosporins Donors Engraftment Fatalities Female Globulins Graft rejection Graft Survival Graft vs Host Disease Graft-versus-host reaction Grafting Grafts Hematologic Neoplasms - drug therapy Hematologic Neoplasms - mortality Hematologic Neoplasms - therapy Hematopoietic Stem Cell Transplantation - methods Hematopoietic Stem Cell Transplantation - mortality Histocompatibility - drug effects Histocompatibility antigen HLA Humans Immunosuppressive Agents - administration & dosage Irradiation Male Medical sciences Methotrexate Middle Aged Peripheral blood Prophylaxis Radiation Stem cell transplantation Stem cells Survival Survival Rate thiotepa Thiotepa - administration & dosage Thymocytes Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Transplantation Conditioning - methods Transplantation, Homologous - methods Transplantation, Homologous - mortality Transplants Transplants & implants Treatment Outcome |
| title | Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin |
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