title: Nonmyeloablative allogeneic hematopoietic cell transplantation.
abstract: Most hematological malignancies occur in older patients. Until recently these patients and those with comorbidities were not candidates for treatment with allogeneic hematopoietic transplantation because they were unable to tolerate the heretofore used high-dose conditioning regimens. The finding that many of the cures achieved with allogeneic hematopoietic transplantation were due to graft-versus-tumor effects led to the development of less toxic and well-tolerated reduced intensity and nonmyeloablative regimens. These regimens enabled allogeneic engraftment, thereby setting the stage for graft-versus-tumor effects. This review summarizes the encouraging early results seen with the new regimens and discusses the two hurdles that need to be overcome for achieving even greater success, disease relapse and graft-versus-host disease.
authors.affiliation: Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA, USA rstorb@fredhutch.org.
authors.forename: Rainer
authors.initials: R
authors.lastname: Storb
authors.affiliation: Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA, USA.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Sandmaier
mesh_terms: D000818:Animals; D015897:Comorbidity; D004195:Disease Models, Animal; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006648:Histocompatibility / Q000235:genetics / Q000276:immunology; D006801:Humans; D009026:Mortality; D012008:Recurrence; D014019:Tissue Donors; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D014184:Transplantation, Homologous; D016896:Treatment Outcome