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• W60342196 startingPage "209" @default.
• W60342196 abstract "Preparative regimens for allogeneic hematopoietic stem cell transplantation (HSCT) must address two immunologic barriers to establish successful hematopoietic engraftment: the host-versus-graft effect (HvG) and the graft-versus-host (GvH) effect. High-dose chemotherapy combined with sublethal doses of radiation therapy has been used to immune suppress the host sufficiently to prevent rejection of donor cells. Although effective in most patients, the original myeloablative regimens based on high dose TBI or busulfan are toxic to non-hematopoietic tissues and are associated with high transplant-associated morbidity and mortality, limiting the potential of this curative treatment to younger patients without underlying end organ dysfunction. Further, conventional ablative regimens require long-term immunosuppression to control GvHD, with resulting immune compromise and toxicity related to these agents. With the recognition that the graft-versus-tumor (GvT) effect is responsible for many of the observed cures following allogeneic transplantation, less intensive and nonmyeloablative preparative regimens have been developed that rely on the graft-versus-disease effect while lessening the myeloablative effect of the transplant. Compared to conventional marrow toxic conditioning regimens in which host hematopoiesis is, in principle fully ablated, ‘‘mini-transplant,’’ or nonmyeloablative regimens utilize immunosuppressive strategies, including low-dose total body irradiation (TBI) and T-cell depleting agents to allow engraftment of allogeneic stem cells, in many instances establishing mixed donor/host lymphohematopoietic chimerism. The goals in the development of these strategies have been 2-fold: to facilitate engraftment of allogeneic stem cells with minimal end organ toxicity, and to modulate graft-versus-host alloreactivity in the direction of GvT while minimizing GvHD." @default.
• W60342196 created "2016-06-24" @default.
• W60342196 creator A5044134864 @default.
• W60342196 creator A5048583088 @default.
• W60342196 date "2008-10-31" @default.
• W60342196 modified "2023-09-25" @default.
• W60342196 title "Reduced-Intensity and Nonmyeloablative Conditioning Regimens" @default.
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