Allogeneic transplantation after a conditioning regimen with ifosfamide, carboplatin and etoposide (ICE).
Successful allogeneic hematopoietic transplants require conditioning regimens with sufficient immunosuppression to allow acceptance of the allograft. Cyclophosphamide, in combination either with TBI or with chemotherapeutic drugs, is the keystone of commonly used regimens. The toxicities of TBI and tumor resistance to cyclophosphamide create a niche for alternative, chemotherapy-based conditioning regimens. We report successful allogeneic stem cell transplantation after an ifosfamide-based regimen with ifosfamide 20 g/m2, carboplatin 1.8 g/m2 and etoposide 3 g/m2 (ICE) in divided doses over 6 days. Engraftment was prompt with neutrophils > or = 20 x 10(9)/l on day +10 and platelets > 20 x 10(9)/l on day +18. Engraftment of donor cells was documented by chromosome analysis and by VNTR analysis. An ifosfamide-based regimen provides sufficient immunosuppression for hematopoietic allograft acceptance in the absence of cyclophosphamide or of TBI.
Oblon
D J
DJ
Bone Marrow Transplant Program, Roger Williams Medical Center, and Department of Medicine, Brown University School of Medicine, Providence, Rhode Island 02908, USA.
Paul
S
S
Yankee
R
R
D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000628:therapy; D016190:Carboplatin / Q000627:therapeutic use*; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D019172:Transplantation Conditioning
D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide