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Nonmyeloablative Conditioning Regimen in Patients with High Risk Acute Myeloid Leukemia: Unrelated and Sibling Allogeneic Hematopoietic Stem Cell Transplantation

  • Conference paper
Acute Leukemias IX

Part of the book series: Haematology and Blood Transfusion Hämatologie und Bluttransfusion ((HAEMATOLOGY,volume 41))

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Summary

It has been recently reported that it is possible to achieve fast engraftment with minimal transplant-related mortality and morbidity by using reduced-intensity preparative regimens based on fludarabine (Flu) combined with busulfan (Bu), antilymphocyte globulin (ATG), cyclophosphamide, melphalan or total body irradiation (TBI). We report our experience with HSCT using three different nonmyeloablative conditioning regimens in 27 high risk patients with acute myeloid leukemia (AML). Fourteen patients were male and 13 female. Twenty-four patients received unmanipulated peripheral blood stem cells (PBSC) from a sibling (n=8) or from a compatible unrelated donor (n=17), respectively. Two patients received bone marrow from HLA-mismatched related (n=l), HLA-compatible unrelated (n=l) donors. The reduced intensity preparative regimens were based on Bu/Flu, Bu/Flu/ATG and TBI/Flu in 10, 7 and 10 patients, respectively. Neutrophil engraftment was observed in 19 out of 21 evaluable patients. Six patients could not be evaluated for engraftment due to early death. Organ toxicity was minimal with mild mucositis and no major bleeding. Acute GvHD was recorded in 50% of the patients. Twelve patients achieved complete remission after transplantation. Complete chimerism was obtained in most patients with stable engraftment. Median follow-up was 7 months. In conclusion, this approach might be of benefit in a carefully selected patient population diagnosed with refractory AML.

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Authors and Affiliations

  1. Clinic of Bone Marrow Transplantation and Haematology/Oncology, Idar-Oberstein, Germany

    N. Basara, E. Roemer, S. Guenzelmann, L. Kraut, B. Schmetzer, A. A. Fauser & M. G. Kiehl

  2. Institute for Transfusion Medicine and Immunohematology, Frankfurt Main, Germany

    C. Seidl & E. Seifried

Authors
  1. N. Basara
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  2. E. Roemer
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  3. S. Guenzelmann
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  4. L. Kraut
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  5. B. Schmetzer
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  6. C. Seidl
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  7. E. Seifried
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  8. A. A. Fauser
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  9. M. G. Kiehl
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Editor information

Editors and Affiliations

  1. Klinikum Grofihadern Med. Klinik III, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München, Germany

    Wolfgang Hiddemann , Torsten Haferlach  & Michael Unterhalt ,  & 

  2. Department of Internal Medicine A, University of Münster, Albert-Schweitzer-Str. 33, 48149, Münster, Germany

    Thomas Büchner

  3. Department of Pediatric Hematology/Oncologic, University of Münster, Albert-Schweitzer-Str. 33, 48149, Münster, Germany

    Jörg Ritter

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© 2003 Springer-Verlag Berlin Heidelberg

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Basara, N. et al. (2003). Nonmyeloablative Conditioning Regimen in Patients with High Risk Acute Myeloid Leukemia: Unrelated and Sibling Allogeneic Hematopoietic Stem Cell Transplantation. In: Hiddemann, W., Haferlach, T., Unterhalt, M., Büchner, T., Ritter, J. (eds) Acute Leukemias IX. Haematology and Blood Transfusion Hämatologie und Bluttransfusion, vol 41. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59358-1_86

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  • DOI: https://doi.org/10.1007/978-3-642-59358-1_86

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63949-4

  • Online ISBN: 978-3-642-59358-1

  • eBook Packages: Springer Book Archive

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