Allogeneic Peripheral Blood Stem Cell Transplantation aftera Non-myeloablative Regimen. Initial Experience

Overview

Background.
Allogeneic transplantation of haematopoietic progenitor cells is a therapeutic method for manypatients, especially with haematological malignancies. However, the conditioning regimen preceding transplantationis rather toxic. During the last years, there is a tendency to replace this toxic regimen by a non-myeloablative andless toxic one and to rely more on posttransplant immune-mediated graft versus tumour reaction.Methods and Results. According to the published data, we chose a combination of fludarabine, busulphan, andanti-T-lymphocyte globulin together with cyclosporin A as a pre-transplant regimen. We transplanted five patientsafter administration of this regimen. We selected high-risk patients due to their higher age or poor status. The earlypost-transplant course was accompanied by mild complications only. Four patients are alive and one patient diedfrom progression of an underlying malignant disease.Conclusions. Contrary to classic transplantation, allogeneic peripheral blood stem cell transplantation aftera non-myeloablative regimen is a very promising method accompanied only with minor early complications.However, its long-term anti-tumour potential can be evaluated after a longer follow-up of greater number of treatedpatients.

Key words:
allogeneic transplantation, non-myeloablative regimen, ATG, busulphan, fludarabine.