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Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin.
Bone Marrow Transplant. 2000 Dec; 26(12):1305-11.BM

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.

Authors+Show Affiliations

Dipartimento di Ematologia, Ospedale San Martino, Genova, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11223970

Citation

Lamparelli, T, et al. "Alternative Donor Transplants for Patients With Advanced Hematologic Malignancies, Conditioned With Thiotepa, Cyclophosphamide and Antithymocyte Globulin." Bone Marrow Transplantation, vol. 26, no. 12, 2000, pp. 1305-11.
Lamparelli T, van Lint MT, Gualandi F, et al. Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin. Bone Marrow Transplant. 2000;26(12):1305-11.
Lamparelli, T., van Lint, M. T., Gualandi, F., Raiola, A. M., Barbanti, M., Sacchi, N., Ficai, G., Ghinatti, C., Bregante, S., Berisso, G., Dominietto, A., Di Grazia, C., Bruno, B., Sessarego, M., Casarino, L., Verdiani, S., & Bacigalupo, A. (2000). Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin. Bone Marrow Transplantation, 26(12), 1305-11.
Lamparelli T, et al. Alternative Donor Transplants for Patients With Advanced Hematologic Malignancies, Conditioned With Thiotepa, Cyclophosphamide and Antithymocyte Globulin. Bone Marrow Transplant. 2000;26(12):1305-11. PubMed PMID: 11223970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alternative donor transplants for patients with advanced hematologic malignancies, conditioned with thiotepa, cyclophosphamide and antithymocyte globulin. AU - Lamparelli,T, AU - van Lint,M T, AU - Gualandi,F, AU - Raiola,A M, AU - Barbanti,M, AU - Sacchi,N, AU - Ficai,G, AU - Ghinatti,C, AU - Bregante,S, AU - Berisso,G, AU - Dominietto,A, AU - Di Grazia,C, AU - Bruno,B, AU - Sessarego,M, AU - Casarino,L, AU - Verdiani,S, AU - Bacigalupo,A, PY - 2001/2/27/pubmed PY - 2001/7/13/medline PY - 2001/2/27/entrez SP - 1305 EP - 11 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 26 IS - 12 N2 - 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. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/11223970/Alternative_donor_transplants_for_patients_with_advanced_hematologic_malignancies_conditioned_with_thiotepa_cyclophosphamide_and_antithymocyte_globulin_ L2 - https://doi.org/10.1038/sj.bmt.1702719 DB - PRIME DP - Unbound Medicine ER -