Nonmyeloablative preparative regimens for allogeneic hematopoietic transplantation. Biology and current indications

Oncology (Williston Park). 2003 Jan;17(1):94-100; discussion 103-7.

Abstract

High-dose myeloablative therapy with allogeneic hematopoietic transplantation is an effective treatment for hematologic malignancies, but this approach is associated with a high risk of complications. The use of relatively nontoxic, nonmyeloablative, or reduced-intensity preparative regimens still allows engraftment and the generation of graft-vs-malignancy effects, is potentially curative for susceptible malignancies, and reduces the risk of treatment-related morbidity. Two general strategies along these lines have emerged, based on the use of (1) immunosuppressive chemotherapeutic drugs, usually a purine analog in combination with an alkylating agent, and (2) low-dose total body irradiation, alone or in combination with fludarabine (Fludara).

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Alkylating / therapeutic use
  • Bone Marrow Transplantation*
  • Graft vs Tumor Effect
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Neoplasms / therapy
  • Peripheral Blood Stem Cell Transplantation*
  • Transplantation, Homologous
  • Whole-Body Irradiation

Substances

  • Antineoplastic Agents, Alkylating
  • Immunosuppressive Agents