Reduced intensity conditioning for allogeneic hematopoietic cell transplantation: Current perspectives
Reduced intensity conditioning for allogeneic hematopoietic cell transplantation: Current perspectives
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DOI：
10.1016/j.bbmt.2006.10.015
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发表时间：
2007-01-01
影响因子：
4.3
通讯作者：
Childs, Richard W.
中科院分区：
文献类型：
--
作者：
Sandmaier, Brenda M.;Mackinnon, Stephen;Childs, Richard W.
清髓性预处理后的异基因HCT是恶性血液病患者的有效治疗方法。在过去的十年中，为了将这种治疗扩展到老年患者或合并症患者，已经开发了强度降低或真正非清髓性方案。降低强度方案的基本原理是提供一定程度的肿瘤杀伤，降低方案相关的发病率和死亡率，然后依靠移植物抗肿瘤（GVT）效应根除剩余的恶性细胞，而非清髓性方案主要依赖于GVT效应。在这篇文章中，3个代表性的方法进行了描述，展示了造血和非造血恶性肿瘤的临床应用。目前的挑战包括控制GVHD，同时允许GVT发生。将来，在选定的恶性肿瘤中，将使用降低强度和非清髓性预处理的临床试验与清髓性预处理进行比较，以将应用扩展到标准风险患者。(c)2007年美国血液和骨髓移植学会。
Allogeneic HCT after myeloablative conditioning is an effective therapy for patients with hematologic malignancies. In an attempt to extend this therapy to older patients or those with comorbidities, reduced intensity or truly nonmyeloablative regimens have been developed over the past decade. The principle underlying reduced intensity regimens is to provide some tumor kill with lessened regimen-related morbidity and mortality and then rely on graft-versus-tumor (GVT) effects to eradicate remaining malignant cells, whereas nonmyeloablative regimens rely primarily on GVT effects. In this article, 3 representative approaches are described, demonstrating the clinical application for hematopoietic and nonhematopoietic malignancies. Current challenges include controlling GVHD while allowing GVT to occur. In the future, clinical trials using reduced intensity and nonmyeloablative conditioning will be compared with myeloablative conditioning in selected malignancies to extend the application to standard-risk patients. (c) 2007 American Society for Blood and Marrow Transplantation.