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Results of an outpatient‐based stem cell allotransplant program using nonmyeloablative conditioning regimens
Author(s) -
RuizArgüelles Guillermo J.,
GómezAlmaguer David,
RuizArgüelles Alejandro,
GonzálezLlano Oscar,
Cantú Olga G.,
JaimePérez José C.
Publication year - 2001
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.1051
Subject(s) - medicine , fludarabine , cyclophosphamide , leukemia , chronic myelogenous leukemia , transplantation , surgery , hematopoietic stem cell transplantation , stem cell , gastroenterology , chemotherapy , biology , genetics
Using non‐myeloablative, immunosuppressive, fludarabine (FLU)‐based conditioning regimens, we have performed allogeneic peripheral blood stem cell transplants in 26 patients (8 with chronic myelogenous leukemia, 6 with acute myelogenous leukemia, 10 with acute lymphoblastic leukemia, 1 with myelodysplasia, and 1 with thalassemia major). Conditioning consisted of FLU/busulphan/cyclophosphamide/cyclosporin‐A (CyA)/methotrexate, or FLU/melphalan/CyA/methotrexate. The median granulocyte recovery time to 0.5 × 10 9 /l was 11 days, whereas the median platelet recovery time to 20 × 10 9 /l was 12 days. Twelve patients did not need red blood cell transfusions, and 8 did not need platelet transfusions. In 21 individuals (81%), the procedure could be completed fully on an outpatient basis. Follow‐up times range between 30 and 600 days: one patient failed to engraft and recovered endogenous hemopoiesis; six out of 26 patients developed acute graft‐versus‐host disease (GVHD) whereas 7/22 developed chronic GVHD. Twelve patients (46%) have died, nine of them with a relapsing disease and three with GVHD; median post‐transplant survival (SV) was 300 days, whereas the 12‐month SV was 42%. The 100‐day mortality was 3.8% and the transplant‐related mortality was 11.5%. This procedure is substantially less costly than its counterpart, using in‐hospital myeloablative conditioning regimens, and it may represent another approach in the management of patients requiring an allogeneic stem cell transplant. Am. J. Hematol. 66:241–244, 2001. © 2001 Wiley‐Liss, Inc.