Background: A new nonmyeloablative stem cell transplantation (NSCT) appears as a new technique for some oncohematologic patients. Generally a low non relapse mortality without any loss of antitumoral effect make this approach very attractive. However, the incidence of GVHD is still a common complication which causes some deaths. Objectives: to evaluate the toxicity of 11 patients in whom a NSCT was performed , preceded (n=2) or no by autologous SCT (n=9). Methods: from June 01 through October 03, 11 patients (range age 21 to 63) with oncohematologic diseases (1 non-Hodgkin’s lymphoma, 4 Hodgkin’s disease, 4 Multyple Myeloma, 1 acute myeloblastic leukemia, 1 chronic lymphocitic leukemia) underwent a NSCT. In nine of them were also performed an autologous SCT ( 45 to 120 days before) because of their advanced disease situation. As conditioning for autologous SCT were given Melfalan 200 mg/m2 (4) and BEAM (5) and for NSCT consisted of fludarabine (90 mg/m2) and TBI of 2 Gy, followed by infusion of peripheral blood from sibling donors. Results: Seven patients developed neutropenic fever during the NSCT while only 2 of them had positive CMV antigenemia. At day 84 after NSCT, 90 % and 70% of patients showed a complete myeloid and lymphoid chimerism. Acute grade II-IV GVHD was present in four patients. Among 11 patients, 4 had chronic GVHD and 3 patients are still at risk of developing this complication. At day 100, non relapse mortality was 0%. To date 7 patients are alive (6 in complete remission and one with minimal residual disease) while 3 died because of progression disease and one of respiratory failure (pulmonary aspergillosis and obliterans bronchiolatis). Conclusion: We think these results are satisfactory and as other authors we would have to explore this new approach in some kind of hematologic patients to put in perspective this new procedure.
Full conference title:
30th Annual Meeting of the European Group for Blood and Marrow Transplantation
- EBMT 2004