Reducing transplant toxicity

被引:11
作者
Feinstein, L
Storb, R
机构
[1] Fred Hutchinson Canc Res Ctr, Div Clin Res, Program transplantat Biol, Seattle, WA 98109 USA
[2] Univ Washington, Sch Med, Div Oncol, Dept Med, Seattle, WA 98195 USA
关键词
D O I
10.1097/00062752-200111000-00005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Conventional myeloablative allogeneic hematopoietic cell transplantation produces considerable morbidity and mortality. These generally limit this treatment to patients in good medical condition who are younger than 55 years of age. T-cell-mediated graft-versus-tumor effects play a key role in the elimination of malignancy after allografting. Several investigators have sought to reduce regimen-related toxicities while optimizing graft-versus-tumor effects. Strategies can be broadly classified as (1) reduced-intensity regimens that retain some toxicity, and (2) minimally myelosuppressive regimens that rely on immunosuppression for allogeneic engraftment and resultant graft-versus-tumor effects. Although follow-up has been short, preliminary results are encouraging. Current challenges include defining a regimen that will facilitate full donor engraftment while minimizing toxicities and graft-versus-host disease. If long-term efficacy is demonstrated, such strategies will expand the options for patients who would not qualify for conventional allogeneic transplants. (C) 2001 Lippincott Williams & Wilkins, Inc.
引用
收藏
页码:342 / 348
页数:7
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