By Mary J. Laughlin, Hillard M. Lazarus
Across the world well-known physicians and researchers overview either the fundamentals of allogeneic stem mobile transplantation and up to date advances within the box, quite as they relate to antitumor results and graft-versus-host sickness additionally they offer particular decision-tree analyses to steer clinicians in settling on and handling their allogeneic transplant sufferers. The techniques mentioned conceal numerous components, starting from stem mobile mobilization in basic donors, to symptoms for allogeneic transplantation except hematologic malignancies, to using nonmyeloablative conditioning regimens. The authors additionally discover new advancements within the optimum collection of unrelated allogeneic grafts (e.g., matched unrelated donor, in part mismatched friend, or umbilical wire blood), the use allogeneic peripheral blood stem mobile vs marrow-derived grafts for transplantation, and the kinetics of immune reconstitution after transplantation.
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Extra resources for Allogeneic Stem Cell Transplantation (1st Edition)
The study included children and adults, with the median age being only 25 yr. Of 18 patients who underwent transplant, 6 who were transplanted in CR1, 1 in CR2, and 2 in first relapse remained leukemia free. The preparative regimen involved TBI and cyclophosphamide. Of 6 who were transplanted in CR1, 1 patient was in CR1, and 2 patients, while in second remission, remained leukemia-free at a median follow-up of 17 mo. The probability of LFS at 2 yr was 49%, which is similar to rates reported for matched-sibling SCT (39).
Using semiquantitative PCR for the detection of the leukemia “clonespecific” immunoglobulin heavy chain or T cell receptor gene rearrangement, these studies have shown that persistent MRD detection at various time points following achievement of morphologic and cytogenetic remission is a highly significant and independent prognosticator of relapse (12,13). Less is known about the significance of MRD detection in adult ALL. Brisco et al. studied 27 adults with B lineage ALL for MRD in CR1. Eight of nine patients with higher levels of disease (levels >10–3) detected using semiquantitative PCR relapsed, compared to 6 of 13 patients with lower MRD levels (levels <10–3) (14).
Hematopoietic Cell Transplantation, 2nd ed. Blackwell Science, London, 1999, pp. 168–175. 48. Stein AS, Forman SJ. Autologous hematopoietic cell transplantation for acute myeloid leukemia. In: Thomas ED, Blume KG, Forman SJ, eds. Hematopoietic Cell Transplantation, 2nd ed. Blackwell Science, London, 1999, pp. 287–295. 49. Miller CB, Rowlings PA, Zhang MJ, et al. The effect of graft purging with 4-hydroperoxycyclophosphamide in autologous bone marrow transplantation for acute myelogenous leukemia.
Allogeneic Stem Cell Transplantation (1st Edition) by Mary J. Laughlin, Hillard M. Lazarus