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Prepublished online as a Blood First Edition Paper on June 5, 2003; DOI 10.1182/blood-2003-02-0482. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-02-0482v1 102/6/2021    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Maris, M. B. Articles by Storb, R. Search for Related Content PubMed PubMed Citation Articles by Maris, M. B. Articles by Storb, R. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 September 2003, Vol. 102, No. 6, pp. 2021-2030 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS HLA-matched unrelated donor hematopoietic cell transplantation after nonmyeloablative conditioning for patients with hematologic malignancies Michael B. Maris, Dietger Niederwieser, Brenda M. Sandmaier, Barry Storer, Monic Stuart, David Maloney, Effie Petersdorf, Peter McSweeney, Michael Pulsipher, Ann Woolfrey, Thomas Chauncey, Ed Agura, Shelly Heimfeld, John Slattery, Ute Hegenbart, Claudio Anasetti, Karl Blume, and Rainer Storb From the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; University of Leipzig, Leipzig, Germany; Stanford University, Palo Alto, CA; University of Colorado, Denver, CO; University of Utah, Salt Lake City, UT; Seattle Veterans Administration Medical Center, Seattle, WA; and Baylor University, Dallas, TX. A hematopoietic cell transplantation (HCT) approach was developed for elderly or ill patients with hematologic malignancies that employed nonmyeloablative conditioning to avoid common regimen-related toxicities and relied on graft-versus-tumor effects for control of malignancy. Eighty-nine patients, median age 53 years, were given fludarabine (90 mg/m2) and 2 Gy total body irradiation. Marrow (n = 18) or granulocyte colony-stimulating factor (G-CSF)–stimulated peripheral blood mononuclear cells (G-PBMCs; n = 71) were transplanted from unrelated donors matched for human leukocyte antigen A (HLA-A), -B, -C antigens and -DRB1 and -DQB1 alleles. Postgrafting immunosuppression included mycophenolate mofetil and cyclosporine. Donor T-cell chimerism was higher for G-PBMCs compared with marrow recipients. Durable engraftment was observed in 85% of G-PBMCs and 56% of marrow recipients. Cumulative probabilities of grade II, III, and IV acute graft-versus-host disease (GVHD) were 42%, 8%, and 2%, respectively. Nonrelapse mortality at day 100 and at 1 year was 11% and 16%, respectively. One-year overall survivals and progression-free survivals were 52% and 38%, respectively. G-PBMC recipients had improved survival (57% vs 33%) and progression-free survival (44% vs 17%) compared with marrow recipients. HLA-matched unrelated donor HCT after nonmyeloablative conditioning is feasible in patients ineligible for conventional HCT. G-PBMCs conferred higher donor T-cell chimerism, greater durable engraftment, and better progression-free and overall survivals compared with marrow. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: M. A. Pulsipher, P. Chitphakdithai, B. R. Logan, S. F. Leitman, P. Anderlini, J. P. Klein, M. M. Horowitz, J. P. Miller, R. J. King, and D. L. Confer Donor, recipient, and transplant characteristics as risk factors after unrelated donor PBSC transplantation: beneficial effects of higher CD34+ cell dose Blood, September 24, 2009; 114(13): 2606 - 2616. [Abstract] [Full Text] [PDF] D. H. Salinger, D. K. Blough, P. Vicini, C. Anasetti, P. V. O'Donnell, B. M. Sandmaier, and J. S. 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