[Non-myeloablative allogeneic stem cell transplantation].
BACKGROUND
Several haematological malignancies can be cured using allogeneic stem cell transplantation (SCT). Maximal tolerable chemoradiotherapy doses are given as part of the conditioning-regimen. This treatment causes substantial toxicity, and the procedure is therefore restricted to patients younger than 60 years without co-morbidity. Non-myeloablative allogeneic SCT, is a treatment modality that can be offered to patients up to 70 years of age and to younger patients with co-morbidity.


METHODS
21 patients (17 men and 4 women) with different haematological malignancies, have been treated with non-myeloablative allogeneic SCT in our institution from October 2000 to May 2005.


RESULTS
The transplant procedure was relatively non-toxic. Four patients required transfusions and 3 required empirical antibiotic treatment, which is always necessary after myoablavative allogen SCT. A stable donor chimerism was achieved for most of our patients before day 84. 11 patients suffered from acute graft versus host disease (GVHD), 6 with debut of symptoms after day 100. 11 patients developed chronic GVHD. 14 patients are alive and 7 are dead; 2 due to transplant-related complications and 5 due to disease progression.


CONCLUSIONS
We have shown that non-myeloablative allogeneic SCT is feasible with an acceptable toxicity. Acute and chronic GVHD is still a substantial problem. Prospective studies with adequate controls are warranted to determine the future role of non-myeloablative allogeneic SCT.
Dalgaard
Jakob
J
Seksjon for blodsykdommer, Medisinsk avdeling, Rikshospitalet-Radiumhospitalet, 0027 Oslo. jakob.dalgaard@sb-hf.no
Fløisand
Yngvar
Y
Stenersen
Margurethe
M
Egeland
Torstein
T
Brinch
Lorentz
L
D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome