Defining the intensity of conditioning regimens: working definitions.
Defining conditioning regimen intensity has become a critical issue for the hemopoietic stem cell transplant (HSCT) community. In the present report we propose to define conditioning regimens in 3 categories: (1) myeloablative (MA) conditioning, (2) reduced-intensity conditioning (RIC), and (3) nonmyeloablative (NMA) conditioning. Assignment to these categories is based on the duration of cytopenia and on the requirement for stem cell (SC) support: MA regimens cause irreversible cytopenia and SC support is mandatory. NMA regimens cause minimal cytopenia, and can be given also without SC support. RIC regimens do not fit criteria for MA or NMA regimens: they cause cytopenia of variable duration, and should be given with stem cell support, although cytopenia may not be irreversible. This report also assigns commonly used regimens to one of these categories, based upon the agents, dose, or combinations. Standardized classification of conditioning regimen intensities will allow comparison across studies and interpretation of study results.
Bacigalupo
Andrea
A
San Martino Hospital, Genoa, Italy. andrea.bacigalupo@hsanmartino.it
Ballen
Karen
K
Rizzo
Doug
D
Giralt
Sergio
S
Lazarus
Hillard
H
Ho
Vincent
V
Apperley
Jane
J
Slavin
Shimon
S
Pasquini
Marcelo
M
Sandmaier
Brenda M
BM
Barrett
John
J
Blaise
Didier
D
Lowski
Robert
R
Horowitz
Mary
M
D005260:Female; D019337:Hematologic Neoplasms / Q000188:drug therapy / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D019172:Transplantation Conditioning / Q000379:methods*