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Rapid achievement of complete donor chimerism and low regimen-related toxicity after reduced conditioning with fludarabine, carmustine, melphalan and allogeneic transplantation.
Bone Marrow Transplant. 2000 Aug; 26(3):243-50.BM

Abstract

Between August 1998 and July 1999, 21 patients received a novel protocol of reduced conditioning with fludarabine, carmustine and melphalan (FBM) followed by matched-related allogeneic peripheral blood stem cell transplantation (PBSCT) in a prospective multi-center phase I/II study. Cyclosporin A and 'mini-methotrexate' were used for GVHD prophylaxis. Patients were included because of age, advanced disease, previous transplantation or co-morbidity. Hematopoietic engraftment after allogeneic transplantation was rapid with a median white blood count (WBC) >1 x 10(9)/l on day +11 (range 10-17) and a median platelet count >20 x 10(9)/l on day +13 (range 9-36). Donor chimerism was complete in 16/21 (76%) patients at all time points during follow-up and mixed at least on one occasion in 5/21 (24%) patients. The conditioning regimen was well tolerated with low toxicity even in previously transplanted patients. Thirteen patients (62%) developed acute GVHD grades II-IV. Nineteen out of 21 patients achieved complete (CR, n = 15) or partial remission (PR, n = 4) with a median patient follow-up of 354+ days (range 258-577) for patients alive. The reduced intensity protocol FBM is feasible with rapid engraftment, early achievement of complete donor chimerism, low toxicity, especially in heavily pretreated patients, and good response rates in advanced disease patients.

Authors+Show Affiliations

Wäsch R
Department of Hematology and Oncology, Albert-Ludwigs University Medical Center, Freiburg, Germany.
Reisser S
No affiliation info available
Hahn J
No affiliation info available
Bertz H
No affiliation info available
Engelhardt M
No affiliation info available
Kunzmann R
No affiliation info available
Veelken H
No affiliation info available
Holler E
No affiliation info available
Finke J
No affiliation info available

MeSH

AdultAntineoplastic Combined Chemotherapy ProtocolsCarmustineCyclosporineFemaleFollow-Up StudiesGraft vs Host DiseaseHematopoietic Stem Cell TransplantationHumansImmunosuppressive AgentsLeukapheresisMaleMelphalanMethotrexateMiddle AgedNeoplasmsProspective StudiesSurvival AnalysisT-LymphocytesTransplantation ChimeraTransplantation ConditioningTransplantation ToleranceVidarabine

Pub Type(s)

Clinical Trial
Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Multicenter Study

Language

eng

PubMed ID

10967561

Citation

Wäsch, R, et al. "Rapid Achievement of Complete Donor Chimerism and Low Regimen-related Toxicity After Reduced Conditioning With Fludarabine, Carmustine, Melphalan and Allogeneic Transplantation." Bone Marrow Transplantation, vol. 26, no. 3, 2000, pp. 243-50.
Wäsch R, Reisser S, Hahn J, et al. Rapid achievement of complete donor chimerism and low regimen-related toxicity after reduced conditioning with fludarabine, carmustine, melphalan and allogeneic transplantation. Bone Marrow Transplant. 2000;26(3):243-50.
Wäsch, R., Reisser, S., Hahn, J., Bertz, H., Engelhardt, M., Kunzmann, R., Veelken, H., Holler, E., & Finke, J. (2000). Rapid achievement of complete donor chimerism and low regimen-related toxicity after reduced conditioning with fludarabine, carmustine, melphalan and allogeneic transplantation. Bone Marrow Transplantation, 26(3), 243-50.
Wäsch R, et al. Rapid Achievement of Complete Donor Chimerism and Low Regimen-related Toxicity After Reduced Conditioning With Fludarabine, Carmustine, Melphalan and Allogeneic Transplantation. Bone Marrow Transplant. 2000;26(3):243-50. PubMed PMID: 10967561.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid achievement of complete donor chimerism and low regimen-related toxicity after reduced conditioning with fludarabine, carmustine, melphalan and allogeneic transplantation. AU - Wäsch,R, AU - Reisser,S, AU - Hahn,J, AU - Bertz,H, AU - Engelhardt,M, AU - Kunzmann,R, AU - Veelken,H, AU - Holler,E, AU - Finke,J, PY - 2000/9/1/pubmed PY - 2001/2/28/medline PY - 2000/9/1/entrez SP - 243 EP - 50 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 26 IS - 3 N2 - Between August 1998 and July 1999, 21 patients received a novel protocol of reduced conditioning with fludarabine, carmustine and melphalan (FBM) followed by matched-related allogeneic peripheral blood stem cell transplantation (PBSCT) in a prospective multi-center phase I/II study. Cyclosporin A and 'mini-methotrexate' were used for GVHD prophylaxis. Patients were included because of age, advanced disease, previous transplantation or co-morbidity. Hematopoietic engraftment after allogeneic transplantation was rapid with a median white blood count (WBC) >1 x 10(9)/l on day +11 (range 10-17) and a median platelet count >20 x 10(9)/l on day +13 (range 9-36). Donor chimerism was complete in 16/21 (76%) patients at all time points during follow-up and mixed at least on one occasion in 5/21 (24%) patients. The conditioning regimen was well tolerated with low toxicity even in previously transplanted patients. Thirteen patients (62%) developed acute GVHD grades II-IV. Nineteen out of 21 patients achieved complete (CR, n = 15) or partial remission (PR, n = 4) with a median patient follow-up of 354+ days (range 258-577) for patients alive. The reduced intensity protocol FBM is feasible with rapid engraftment, early achievement of complete donor chimerism, low toxicity, especially in heavily pretreated patients, and good response rates in advanced disease patients. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/10967561/Rapid_achievement_of_complete_donor_chimerism_and_low_regimen_related_toxicity_after_reduced_conditioning_with_fludarabine_carmustine_melphalan_and_allogeneic_transplantation_ L2 - https://doi.org/10.1038/sj.bmt.1702512 DB - PRIME DP - Unbound Medicine ER -
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