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Related Collections Neoplasia Transplantation Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 February 2002, Vol. 99, No. 3, pp. 1071-1078 TRANSPLANTATION Limiting transplantation-related mortality following unrelated donor stem cell transplantation by using a nonmyeloablative conditioning regimen Ronjon Chakraverty, Karl Peggs, Rajesh Chopra, Donald W. Milligan, Panagiotis D. Kottaridis, Stephanie Verfuerth, Johanne Geary, Dharsha Thuraisundaram, Kate Branson, Suparno Chakrabarti, Premini Mahendra, Charles Craddock, Anne Parker, Ann Hunter, Geoff Hale, Herman Waldmann, Catherine D. Williams, Kwee Yong, David C. Linch, Anthony H. Goldstone, and Stephen Mackinnon From the Departments of Haematology, University College London Hospital, United Kingdom; University Hospital Birmingham and Heartlands Hospital Birmingham, United Kingdom; Christie Hospital Manchester, United Kingdom; Glasgow Royal Infirmary, United Kingdom; Leicester Royal Infirmary, United Kingdom; and Sir William Dunn School of Pathology, University of Oxford; United Kingdom. A nonmyeloablative conditioning regimen was investigated in 47 patients with hematological malignancy receiving allogeneic progenitor cells from matched, unrelated donors. The median patient age was 44 years. The majority of patients had high-risk features, including having failed a prior transplantation (29 individuals). Twenty of the transplants were mismatched for HLA class I and/or class II alleles. Recipient conditioning consisted of 20 mg CAMPATH-1H on days 8 to 4, 30 mg/m2 fludarabine on days 7 to 3, and 140 mg/m2 melphalan on day 2. Graft-versus-host disease (GVHD) prophylaxis was with cyclosporine A alone. Primary graft failure occurred in only 2 of 44 evaluable patients (4.5%). Chimerism studies in 34 patients indicated that the majority (85.3%) attained initial full donor chimerism. Only 3 patients developed grade III to IV acute GVHD, and no patients have yet developed chronic extensive GVHD. The estimated probability of nonrelapse mortality at day 100 was 14.9% (95% confidence interval [CI], 4.7%-25.1%). With a median follow-up of 344 days (range, 79-830), overall and progression-free survivals at 1 year were 75.5% (95% CI, 62.8%-88.2%) and 61.5% (95% CI, 46.1%-76.8%), respectively. In summary, a nonmyeloablative regimen incorporating in vivo CAMPATH-1H is effective in promoting durable engraftment in most patients and in reducing the risk of severe GVHD following matched unrelated donor transplantation. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: Nonmyeloablative transplantation challenged by experimentation Marlies E. H. M. Van Hoef ; and Stephen Mackinnon Blood 2002 100: 1508-1509. [Full Text] [PDF] This article has been cited by other articles: S. P. Robinson, A. Sureda, C. Canals, N. Russell, D. Caballero, A. Bacigalupo, A. Iriondo, G. Cook, A. Pettitt, G. Socie, et al. Reduced intensity conditioning allogeneic stem cell transplantation for Hodgkin's lymphoma: identification of prognostic factors predicting outcome Haematologica, February 1, 2009; 94(2): 230 - 238. [Abstract] [Full Text] [PDF] F. Ayuk, J. A. Perez-Simon, A. Shimoni, A. 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