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Blood, 30 July 2009, Vol. 114, No. 5, pp. 1099-1109. Prepublished online as a Blood First Edition Paper on May 7, 2009; DOI 10.1182/blood-2009-03-211441. This Article Full Text Full Text (PDF) Supplemental Figures All Versions of this Article: blood-2009-03-211441v1 114/5/1099    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 Google Scholar Articles by Kohrt, H. E. Articles by Lowsky, R. PubMed PubMed Citation Articles by Kohrt, H. E. Articles by Lowsky, R. Related Collections Transplantation Free Research Articles Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  TRANSPLANTATION TLI and ATG conditioning with low risk of graft-versus-host disease retains antitumor reactions after allogeneic hematopoietic cell transplantation from related and unrelated donors Holbrook E. Kohrt1, Brit B. Turnbull2, Kartoosh Heydari1, Judith A. Shizuru1, Ginna G. Laport1, David B. Miklos1, Laura J. Johnston1, Sally Arai1, Wen-Kai Weng1, Richard T. Hoppe3, Philip W. Lavori2, Karl G. Blume1, Robert S. Negrin1, Samuel Strober1, and Robert Lowsky1 Departments of 1 Medicine, 2 Health Research and Policy, and 3 Radiation Oncology, Stanford University School of Medicine, CA A hematopoietic cell transplantation regimen was adapted from a preclinical model that used reduced-intensity conditioning (RIC) and protected against graft-versus-host disease (GVHD) by skewing residual host T-cell subsets to favor regulatory natural killer T cells. One hundred eleven patients with lymphoid (64) and myeloid (47) malignancies received RIC using total lymphoid irradiation (TLI) and antithymocyte globulin (ATG) followed by the infusion of granulocyte colony-stimulating factor-mobilized grafts. Included were 34 patients at least 60 years of age, 32 patients at high risk of lymphoma relapse after disease recurrence following prior autologous transplantation, and 51 patients at high risk of developing GVHD due to lack of a fully human leukocyte antigen (HLA)–matched related donor. Durable chimerism was achieved in 97% of patients. Cumulative probabilities of acute GVHD (grades II-IV) were 2 and 10% of patients receiving related and unrelated donor grafts. Nonrelapse mortality (NRM) at 1 year was less than 4%. Cumulative incidence of chronic GVHD was 27%. The 36-month probability of overall and event-free survival was 60% and 40%, respectively. Disease status at start of conditioning and the level of chimerism achieved after transplantation significantly impacted clinical outcome. The high incidence of sustained remission among patients with active disease at time of transplantation suggests retained graft-versus-tumor reactions. Active trial registration currently at clinicaltrials.gov under IDs of NCT00185640 [ClinicalTrials.gov] and NCT00186615 [ClinicalTrials.gov] . CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. Socie and B. R. Blazar Acute graft-versus-host disease: from the bench to the bedside Blood, November 12, 2009; 114(20): 4327 - 4336. [Abstract] [Full Text] [PDF]

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