[Seventeen cases of nonmyeloablative stem cell transplantation using a conditioning regimen containing fludarabine].
OBJECTIVE
To explore the efficiency and toxicity of non-myeloablative stem cell transplantation (NAST) for hematological disease.


METHODS
Seventeen patients, including 3 acute myeloid leukemia, 6 chronic myelogenous leukemia, 4 severe aplastic anemia, 2 non-Hodgkin's lymphoma, 1 multiple myeloma and 1 myelodysplastic syndromes received NAST from HLA-identical sibling donors. Peripheral blood stem cells were mobilized by G-CSF 300 microg/12 hours x 5 d. (2.15 -10.01) x 10(6) CD(34)(+) cells/kg were transplanted. A non-myeloablative conditioning regimen included fludarabine 30 mg.m(-2).d(-1) x 6 d;busulfan 4 mg.kg(-1).d(-1) x 2 d or cyclophosphamide 50 mg.kg(-1).d(-1) x 2 d and antilymphocytic globulin 12 approximately 15 mg.kg(-1).d(-1) x 4 d. Cyclosporin A was used to prevent graft versus host disease (GVHD) alone and no G-CSF was administered after NAST.


RESULTS
Hematopoiesis reconstitution resumed on day 8 to day 19 (average of day 13). Severe mucositis was absent. Hepatic venoocclusive disease did not occur. Infectious complications were rare. Acute and chronic GVHD each occurred in 5 patients. Idiopathic pneumonia was developed in 5 patients. In the follow-up duration of 120 to 425 days, 16 of the 17 cases had a stable mixed or complete chimerical states. Fourteen of 17 patients are alive.


CONCLUSIONS
NAST is an effective therapy in the treatment of hematological diseases with less complications, less blood transfusion and lower cost.
Wu
De-pei
DP
First Affiliated Hospital, Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China.
Ma
Xiao
X
Sun
Ai-ning
AN
Fu
Zheng-zheng
ZZ
Tang
Xiao-wen
XW
Qiu
Hui-ying
HY
Miao
Miao
M
Liu
Yue-jun
YJ
Li
Cai-xia
CX
Xia
Xue-ming
XM
Lin
Bao-jue
BJ
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D019653:Myeloablative Agonists; D014740:Vidarabine; C024352:fludarabine