Nonmyeloablative conditioning regimens for stem cell transplantation.
| . | . | . | . | . | . | GVHD . | . | ||
|---|---|---|---|---|---|---|---|---|---|
| Transplant Center . | No. Pts. Studied . | Diagnosis . | Conditioning Regimen . | Postgraft Immuno- suppression . | No. Pts. Achieving > 90% Donor Chimerism . | Acute Grade II-IV . | Chronic . | No. Pts. Achieving CR . | Outcome(s) (# or % of Patients) . |
| Abbreviations: CR, complete remission; A, ara-C; AML, acute myelogenous leukemia; ATG, antithymocyte globulin; B, busulfan; C, cisplatin; CLL, chronic lymphocytic leukemia; CSP, cyclosporine; CY, cyclophosphamide; DLI, donor lymphocyte infusion; F, fludarabine; GD, genetic diseases; HM, hematologic malignancies; I, idarubicin; L, lymphoma; M, melphalan; MDS, myelodysplastic syndrome; MP, methylprednisolone; NA, not available; MTX, methotrexate; ST, solid tumors; T, tacrolimus; TBI, total body irradiation; TI, thymic irradiation; 2-CDA, 2-chlorodeoxyadenosine. | |||||||||
| M.D. Anderson26 | 15 | AML/MDS | F+I+A | CSP+MP | 6 | 3 | 0 | 8 | Overall survival: 6 |
| F+I+M | Disease-free survival: 2 | ||||||||
| 2-CDA+A | Median 100 days | ||||||||
| M.D. Anderson29 | 15 | CLL/NHL | F+CY | T±MTX | 8 | 4 | 2 | 8 | Overall survival: 7 |
| F+C+A | 3 after DLI | Median 180 days | |||||||
| M.D. Anderson28 | 86 | HM | F+M | ||||||
| 2- CDA+ M | T+ MTX | 40 of 42 in CR | 34 | 21 | 49 | Overall 2- yr survival: 28% | |||
| 2- yr Disease- free survival: 23% | |||||||||
| 2- yr Non- relapse mortality: 45% | |||||||||
| Jerusalem30 | 26 | HM/GD | F+B+ATG | CSP | 7 | 10 | 9 | NA | Overall survival: 22 |
| 2 after DLI | 2 after DLI | Disease-free survival: 21 | |||||||
| Median 240 days | |||||||||
| Jerusalem31 | 23 | L | F+B+ATG | CSP | 16 | 8 | 4 | NA | Disease-free survival: 10 |
| 2 after DLI | Median 675 days | ||||||||
| NIH32 | 15 | HM/ST | F+CY | CSP | 7 | 10 | 4 | 5 | Overall survival: 8 |
| 3 after stopping CSP | 1 after DLI | 121-409 days posttransplant | |||||||
| 3 after DLI | |||||||||
| Boston33 | 21 | HM | CY+ATG±TI | CSP | NA | 12 | NA | 8 | Overall survival: 11 |
| 7 after DLI | 6 after DLI | Disease-free survival: 7 | |||||||
| Median 445 days | |||||||||
| Seattle36 | 192 | HM | 2 Gy TBI±F | MMF+CSP | NA | 88 | NA | NA | Overall survival: 114 |
| Nonrelapse mortality: 3 | |||||||||
| Relapse mortality: 35 | |||||||||
| Median 289 days | |||||||||
| . | . | . | . | . | . | GVHD . | . | ||
|---|---|---|---|---|---|---|---|---|---|
| Transplant Center . | No. Pts. Studied . | Diagnosis . | Conditioning Regimen . | Postgraft Immuno- suppression . | No. Pts. Achieving > 90% Donor Chimerism . | Acute Grade II-IV . | Chronic . | No. Pts. Achieving CR . | Outcome(s) (# or % of Patients) . |
| Abbreviations: CR, complete remission; A, ara-C; AML, acute myelogenous leukemia; ATG, antithymocyte globulin; B, busulfan; C, cisplatin; CLL, chronic lymphocytic leukemia; CSP, cyclosporine; CY, cyclophosphamide; DLI, donor lymphocyte infusion; F, fludarabine; GD, genetic diseases; HM, hematologic malignancies; I, idarubicin; L, lymphoma; M, melphalan; MDS, myelodysplastic syndrome; MP, methylprednisolone; NA, not available; MTX, methotrexate; ST, solid tumors; T, tacrolimus; TBI, total body irradiation; TI, thymic irradiation; 2-CDA, 2-chlorodeoxyadenosine. | |||||||||
| M.D. Anderson26 | 15 | AML/MDS | F+I+A | CSP+MP | 6 | 3 | 0 | 8 | Overall survival: 6 |
| F+I+M | Disease-free survival: 2 | ||||||||
| 2-CDA+A | Median 100 days | ||||||||
| M.D. Anderson29 | 15 | CLL/NHL | F+CY | T±MTX | 8 | 4 | 2 | 8 | Overall survival: 7 |
| F+C+A | 3 after DLI | Median 180 days | |||||||
| M.D. Anderson28 | 86 | HM | F+M | ||||||
| 2- CDA+ M | T+ MTX | 40 of 42 in CR | 34 | 21 | 49 | Overall 2- yr survival: 28% | |||
| 2- yr Disease- free survival: 23% | |||||||||
| 2- yr Non- relapse mortality: 45% | |||||||||
| Jerusalem30 | 26 | HM/GD | F+B+ATG | CSP | 7 | 10 | 9 | NA | Overall survival: 22 |
| 2 after DLI | 2 after DLI | Disease-free survival: 21 | |||||||
| Median 240 days | |||||||||
| Jerusalem31 | 23 | L | F+B+ATG | CSP | 16 | 8 | 4 | NA | Disease-free survival: 10 |
| 2 after DLI | Median 675 days | ||||||||
| NIH32 | 15 | HM/ST | F+CY | CSP | 7 | 10 | 4 | 5 | Overall survival: 8 |
| 3 after stopping CSP | 1 after DLI | 121-409 days posttransplant | |||||||
| 3 after DLI | |||||||||
| Boston33 | 21 | HM | CY+ATG±TI | CSP | NA | 12 | NA | 8 | Overall survival: 11 |
| 7 after DLI | 6 after DLI | Disease-free survival: 7 | |||||||
| Median 445 days | |||||||||
| Seattle36 | 192 | HM | 2 Gy TBI±F | MMF+CSP | NA | 88 | NA | NA | Overall survival: 114 |
| Nonrelapse mortality: 3 | |||||||||
| Relapse mortality: 35 | |||||||||
| Median 289 days | |||||||||