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Reduced-Intensity and Nonmyeloablative Conditioning Regimens

  • Francine Foss
  • Koen van Besien
Chapter
Part of the Cancer Treatment and Research book series (CTAR, volume 144)

Alternative Conditioning Regimens for Allogeneic Hematopoietic Stem Cell Transplantation

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.

Keywords

Conditioning Regimen Total Body Irradiation Acute GvHD Allogeneic Hematopoietic Stem Cell Transplantation Chronic GvHD 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Medical Oncology and Bone Marrow Transplantation, Yale University School of MedicineNew HavenUSA

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