PURPOSE OF REVIEW: Allogeneic hematopoietic stem cell transplantation was originally developed as a form of rescue from high-dose chemoradiotherapy, which is given both to eradicate malignancy and provide sufficient immunosuppression for allogeneic engraftment. However, it was observed that allogeneic immunocompetent cells transplanted with the stem cells, or arising from them, mediated therapeutic antitumor effects independent of the action of the high-dose therapy. This was termed a graft-versus-tumor effect. This has prompted the recent development of nonmyeloablative conditioning regimens for allogeneic hematopoietic stem cell transplantation that have opened the way to include elderly patients and those with comorbid conditions. RECENT FINDINGS: Recent retrospective studies comparing hematopoietic stem cell transplantation after myeloablative or nonmyeloablative regimens suggested that the use of nonmyeloablative conditioning might be associated with lower transplant-related toxicity, lower nonrelapse mortality, and at least similar intermediate-term progression-free survival. SUMMARY: Hematopoietic stem cell transplantation after nonmyeloablative conditioning might become the procedure of choice also for younger patients. Phase 3 studies are needed to determine outcomes for different diseases and age groups.
PURPOSE OF REVIEW: Allogeneic hematopoietic stem cell transplantation was originally developed as a form of rescue from high-dose chemoradiotherapy, which is given both to eradicate malignancy and provide sufficient immunosuppression for allogeneic engraftment. However, it was observed that allogeneic immunocompetent cells transplanted with the stem cells, or arising from them, mediated therapeutic antitumor effects independent of the action of the high-dose therapy. This was termed a graft-versus-tumor effect. This has prompted the recent development of nonmyeloablative conditioning regimens for allogeneic hematopoietic stem cell transplantation that have opened the way to include elderly patients and those with comorbid conditions. RECENT FINDINGS: Recent retrospective studies comparing hematopoietic stem cell transplantation after myeloablative or nonmyeloablative regimens suggested that the use of nonmyeloablative conditioning might be associated with lower transplant-related toxicity, lower nonrelapse mortality, and at least similar intermediate-term progression-free survival. SUMMARY: Hematopoietic stem cell transplantation after nonmyeloablative conditioning might become the procedure of choice also for younger patients. Phase 3 studies are needed to determine outcomes for different diseases and age groups.
Authors: Scott S Tykodi; Nobuharu Fujii; Nathalie Vigneron; Sharon M Lu; Jeffrey K Mito; Maureen X Miranda; Jeffrey Chou; Lilien N Voong; John A Thompson; Brenda M Sandmaier; Peter Cresswell; Benoît Van den Eynde; Stanley R Riddell; Edus H Warren Journal: Clin Cancer Res Date: 2008-08-15 Impact factor: 12.531
Authors: Frédéric Baron; Brenda M Sandmaier; Barry E Storer; Michael B Maris; Amelia A Langston; Thoralf Lange; Effie Petersdorf; Wolfgang Bethge; Richard T Maziarz; Peter A McSweeney; Michael A Pulsipher; James C Wade; Thomas R Chauncey; Judith A Shizuru; Mohamed L Sorror; Ann E Woolfrey; David G Maloney; Rainer Storb Journal: Biol Blood Marrow Transplant Date: 2007-07-20 Impact factor: 5.742
Authors: Frédéric Baron; Pierre Zachée; Johan Maertens; Tessa Kerre; Aurélie Ory; Laurence Seidel; Carlos Graux; Philippe Lewalle; Michel Van Gelder; Koen Theunissen; Evelyne Willems; Marie-Paule Emonds; Ann De Becker; Yves Beguin Journal: J Hematol Oncol Date: 2015-02-06 Impact factor: 17.388
Authors: Ludovic Belle; France Bruck; Jacques Foguenne; André Gothot; Yves Beguin; Frédéric Baron; Alexandra Briquet Journal: PLoS One Date: 2012-12-20 Impact factor: 3.240