TY - JOUR
T1 - Chimerism and clinical outcomes of 110 recipients of unrelated donor bone marrow transplants who underwent conditioning with low-dose, single-exposure total body irradiation and cyclophosphamide
AU - Girgis, Mark
AU - Hallemeier, Chris
AU - Blum, William
AU - Brown, Randy
AU - Lin, Hsiu San
AU - Khoury, Hanna
AU - Tim Goodnough, L.
AU - Vij, Ravi
AU - Devine, Steve
AU - Wehde, Marita
AU - Postma, Stacey
AU - Oza, Aarti
AU - DiPersio, John
AU - Adkins, Douglas
PY - 2005/4/15
Y1 - 2005/4/15
N2 - We hypothesized that low-dose (550-cGy), single-exposure, high dose rate (30 cGy/ min) total body irradiation (TBI) with cyclophosphamide as conditioning for HLA-compatible unrelated donor (URD) bone marrow transplantation (BMT) would result in donor chimerism (DC) with a low risk for serious organ toxicity and treatment-related mortality (TRM). Twenty-six patients with good risk diagnoses (acute leukemia in first complete remission [CR] and chronic-phase chronic myelogenous leukemia [CML]) and 84 with poor risk diagnoses underwent this regimen and URD BMT. Unsorted marrow nucleated cells were assessed for chimerism using VNTR probes. All DC occurred in 78 (86%) of 91 evaluable patients at 1 or more follow-up points. Graft failure occurred in 7 (7.7%) patients. Fatal organ toxicity occurred in only 2% of patients. TRM rates through 2 years of follow-up were 19% and 42% in those with good and poor risk diagnoses, respectively. Overall and disease-free survival rates in the good risk group were 47% and 40%, respectively, and in the poor risk group they were 25% and 21%, respectively, at a median follow-up for living patients of 850 days (range, 354-1588 days). This regimen resulted in 100% DC in most patients undergoing URD BMT with a relatively low risk for fatal organ toxicity and TRM.
AB - We hypothesized that low-dose (550-cGy), single-exposure, high dose rate (30 cGy/ min) total body irradiation (TBI) with cyclophosphamide as conditioning for HLA-compatible unrelated donor (URD) bone marrow transplantation (BMT) would result in donor chimerism (DC) with a low risk for serious organ toxicity and treatment-related mortality (TRM). Twenty-six patients with good risk diagnoses (acute leukemia in first complete remission [CR] and chronic-phase chronic myelogenous leukemia [CML]) and 84 with poor risk diagnoses underwent this regimen and URD BMT. Unsorted marrow nucleated cells were assessed for chimerism using VNTR probes. All DC occurred in 78 (86%) of 91 evaluable patients at 1 or more follow-up points. Graft failure occurred in 7 (7.7%) patients. Fatal organ toxicity occurred in only 2% of patients. TRM rates through 2 years of follow-up were 19% and 42% in those with good and poor risk diagnoses, respectively. Overall and disease-free survival rates in the good risk group were 47% and 40%, respectively, and in the poor risk group they were 25% and 21%, respectively, at a median follow-up for living patients of 850 days (range, 354-1588 days). This regimen resulted in 100% DC in most patients undergoing URD BMT with a relatively low risk for fatal organ toxicity and TRM.
UR - http://www.scopus.com/inward/record.url?scp=20144386824&partnerID=8YFLogxK
U2 - 10.1182/blood-2003-07-2346
DO - 10.1182/blood-2003-07-2346
M3 - Article
C2 - 15126314
AN - SCOPUS:20144386824
SN - 0006-4971
VL - 105
SP - 3035
EP - 3041
JO - Blood
JF - Blood
IS - 8
ER -