Bone Marrow Transplantation in Patients with Fanconi Anemia: Experience with Cyclophosphamide and Total Body Irradiation Conditioning Regimen

1997 ◽  
Vol 14 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Hassan Solh ◽  
Koneti Rao ◽  
Antonio Martins da Cunha ◽  
Andrew Padmos ◽  
Kwesi Sackey ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Fanconi Anemia ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Conditioning Regimen ◽  
Total Body

Preclinical analysis of treosulfan in combination with total body irradiation as conditioning regimen prior to bone marrow transplantation in rats

2009 ◽  
Vol 31 (4) ◽  
pp. 595-600 ◽  
Author(s):  
Vicky Sender ◽  
Nicole Hofmeister-Mielke ◽  
Kathrin Sievert ◽  
Jens Peter Teifke ◽  
Heike Vogel ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Conditioning Regimen ◽  
Total Body

scholarly journals Prevention of graft rejection following bone marrow transplantation

Blood ◽  
1981 ◽  
Vol 57 (1) ◽  
pp. 9-12
Author(s):  
RP Gale ◽  
W Ho ◽  
S Feig ◽  
R Champlin ◽  
A Tesler ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Aplastic Anemia ◽  
Total Body Irradiation ◽  
Graft Rejection ◽  
Marrow Transplantation ◽  
Low Dose ◽  
Conditioning Regimen ◽  
Actuarial Survival ◽  
Total Body

Bone marrow transplantation from an HLA-identical sibling is increasingly used in the treatment of severe aplastic anemia. One major problem with this approach is graft rejection that occurs in 25%-60% of patients conditioned for transplantation with cyclophosphamide. At most transplant centers it has been difficult to accurately identify patients at high risk for graft rejection. We studied a conditioning regimen of cyclophosphamide (200 mg per kg) and low-dose total body irradiation (3 Gy; equivalent to 300 rad) in 23 consecutive unselected patients with aplastic anemia followed for a minimum of 6 mo. There was only one episode of graft rejection. Graft-versus-host disease and interstitial pneumonitis were not increased by the more intensive conditioning regimen. Actuarial survival was 61% at 1 yr and 49% at 2.5 yr. Cyclophosphamide and low-dose total body irradiation is an effective conditioning regimen in patients with aplastic anemia. It may be particularly useful when accurate predictive tests of graft rejection are not available as is the case in most transplant centers.

scholarly journals Prevention of graft rejection following bone marrow transplantation

Blood ◽  
1981 ◽  
Vol 57 (1) ◽  
pp. 9-12 ◽  
Author(s):  
RP Gale ◽  
W Ho ◽  
S Feig ◽  
R Champlin ◽  
A Tesler ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Aplastic Anemia ◽  
Total Body Irradiation ◽  
Graft Rejection ◽  
Marrow Transplantation ◽  
Low Dose ◽  
Conditioning Regimen ◽  
Actuarial Survival ◽  
Total Body

Abstract Bone marrow transplantation from an HLA-identical sibling is increasingly used in the treatment of severe aplastic anemia. One major problem with this approach is graft rejection that occurs in 25%-60% of patients conditioned for transplantation with cyclophosphamide. At most transplant centers it has been difficult to accurately identify patients at high risk for graft rejection. We studied a conditioning regimen of cyclophosphamide (200 mg per kg) and low-dose total body irradiation (3 Gy; equivalent to 300 rad) in 23 consecutive unselected patients with aplastic anemia followed for a minimum of 6 mo. There was only one episode of graft rejection. Graft-versus-host disease and interstitial pneumonitis were not increased by the more intensive conditioning regimen. Actuarial survival was 61% at 1 yr and 49% at 2.5 yr. Cyclophosphamide and low-dose total body irradiation is an effective conditioning regimen in patients with aplastic anemia. It may be particularly useful when accurate predictive tests of graft rejection are not available as is the case in most transplant centers.

Comparison of Conditioning Regimens with or without Total Body Irradiation in Bone Marrow Transplantation from an Alternative Donor.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5172-5172 ◽  
Author(s):  
Hiromasa Yabe ◽  
Shunichi Kato ◽  
Miharu Yabe ◽  
Kazuko Kudo ◽  
Hiroshi Yagasaki ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Low Dose ◽  
Conditioning Regimen ◽  
Alternative Donor ◽  
Conditioning Regimens ◽  
Total Body

Abstract An optimum conditioning regimen is indispensable in improving outcomes for patients with acquired aplastic anemia (AA) who receive bone marrow transplantation (BMT) from an alternative donor. Although high-dose total body irradiation (TBI) is effective in enhancing engraftment, intensive conditioning regimens are associated with increased regimen-related toxicity, which results in a decreased success rate. Currently, two different approaches are primarily used; a conditioning regimen including low-dose TBI and a fludarabin-based regimen without TBI. We attempt to clarify the efficacy and regimen-related toxicity of these two approaches. Ten patients (7 males, 3 females; median age 12y; range 9–17y) underwent an alternative donor transplant following a conditioning regimen with low-dose TBI (TBI group); patients received cyclophosphamide (50 mg/kg/d on days −5 to −2), antithymocyte globulin (Thymoglobulin, 2.5 mg/kg/d on days −5 to −2) and TBI (2.5 Gy x 2 on day −1). The donor was unrelated in 9 patients (3 were serologically HLA A or B antigen mismatched; 3 were serologically HLA DR antigen mismatched, 1 was both serologically and genotypically DR antigen mismatched; 1 was genotypically DRB1 mismatched; 1 was a genotypically complete match) and was a family member in 1 patient (serologically HLA A-mismatched father). Twelve patients (6 males, 6 females; median age, 11 y; range 2–20 y) received a conditioning regimen of fludarabine (25 mg/kg/d on days −5 to −2), cyclophosphamide (750 mg/m 2 /d on days −5 to −2), thymoglobulin (1.5 mg/kg/d on days −5 to −2) and thoracoabdominal irradiation (TAI, 3Gy x 1 on day −1) (TAI group). The donor was unrelated in 11 patients (8 were genotypically complete matches, and 3 were genotypically DRB1 antigen mismatched) and a family member in 1 patient (3 antigen-mismatched mother). The source of stem cells was unmanipulated bone marrow. Graft versus host disease (GVHD) prophylaxis consisted of tacrolimus (0.02 mg/kg from day −1) and short-term methotrexate. Rejection was seen in one patient in each group. The doses of infused nucleated marrow cells were less than 2.0 x 10 8 /kg in both patients, and both patients then received a second transplant and achieved full donor chimerism. Acute GVHD grade II-IV developed in 2/10 evaluable patients in the TBI group and in 3/12 patients in the TAI group. Chronic GVHD developed in 5/9 evaluable patients in TBI group and 3/10 evaluable patients in TAI group. Median follow up was 9 months (4–27 months) in the TBI group and 21 months (3–33 months) in the TAI group. Both conditioning regimens were well tolerated and effective even in HLA-mismatched unrelated donor transplantation. Long-term follow up is warranted in order to compare the late sequelae in both regimens.

Unrelated-Donor Bone Marrow Transplantation with a Conditioning Regimen Including Fludarabine, Busulfan, and 4 Gy Total Body Irradiation

2007 ◽  
Vol 85 (3) ◽  
pp. 256-263 ◽  
Author(s):  
Yasushi Onishi ◽  
Shin-ichiro Mori ◽  
Shigeru Kusumoto ◽  
Kyoko Sugimoto ◽  
Daigo Akahane ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Total Body Irradiation ◽  
Marrow Transplantation ◽  
Conditioning Regimen ◽  
Unrelated Donor ◽  
Donor Bone Marrow ◽  
Total Body
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