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Half-matched transplants widen pool of donors for leukemia and lymphoma
Date:7/7/2011

e Marrow Transplant Program pioneered the use of a chemotherapy drug called cyclophosphamide after the transplant to minimize the effects of GVHD. The drug wipes out the patient's immune system, leaving the transplanted blood stem cells intact. The stem cells create new disease-free blood cells in the patient.

The investigators also believe that a lower-intensity "conditioning" regimen of chemotherapy and radiation before the haploidentical marrow transplant may help prevent severe GVHD. The outpatient conditioning treatment lasts six days. Then, the donor's bone marrow is harvested and, that same day, infused intravenously into the patient. This is followed by two days of high-dose cyclophosphamide, and then, other immune-suppressing drugs.

Within 16 to 24 days, patients begin forming new blood cells including white blood cells and platelets, important for fighting infection and clotting blood. Thirty to 40 percent of patients are able to receive their transplants on an outpatient basis, but some patients are admitted for fevers or infections. Patients are monitored carefully and remain in proximity to the hospital for 60 days after the transplant.

Patients receiving cord blood transplants follow a similar regimen, but have seven days of pre-transplant chemo and radiation therapy and receive cord blood from two separate donors.

Fuchs anticipates that haploidentical bone marrow transplants may be tested more widely in nonmalignant diseases, such as aplastic anemia, lupus, and sickle cell anemia. Haploidentical transplants using post-transplant cyclophosphamide are being performed in medical centers outside of the U.S., including Italy, Thailand, Singapore, Israel, Australia, Belgium and England.


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Contact: Vanessa Wasta
wasta@jhmi.edu
410-955-1287
Johns Hopkins Medical Institutions
Source:Eurekalert

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