'Mini transplant' patients' outcomes similar using related and unrelated d...( SEATTLE People who undergo nonmyelo...),Health

SEATTLE People who undergo nonmyeloablative stem-cell transplants, or mini transplants, for leukemia, lymphoma and other blood cancers have comparable outcomes regardless of whether they receive tissue-matched stem cells from a related or unrelated donor, according to new findings by researchers at Fred Hutchinson Cancer Research Center.

The research by Marco Mielcarek, M.D., and colleagues in the Hutchinson Centers Clinical Research Division appear in the December issue of the journal Biology of Blood and Marrow Transplantation.

The main message for referring physicians is that if the patient is a candidate for a nonmyeloablative, or mini, transplant but does not have a suitable related donor, the transplant should not be delayed provided a matched unrelated donor is available, said Mielcarek, the lead author of the paper.

This is a significant finding because historically, standard (myeloablative) stem-cell transplants from unrelated matched donors have been associated with increased risk of non-relapse mortality and decreased overall survival compared to transplants from matched related donors. Only 30 percent of patients with hematologic malignancies who might benefit from a stem-cell transplant have a matched related donor.

The combination of immunosuppressive drugs and the unique biology of the mini transplant may be the reasons behind the research results, Mielcarek said.

The Hutchinson Centers pioneering development 10 years ago of the mini transplant, a kinder, gentler treatment that doesnt require the intensive radiation and chemotherapy associated with standard stem-cell transplants, made the therapy available to thousands of older patients who were medically unable to withstand the rigors of traditional transplantation.

Such transplants do not require a patient's marrow be destroyed with high-dose radiation and chemotherapy prior to the infusion of donor cells. The technique involves minimal radiation and substantially r
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