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Studies Investigate New Methodologies to Improve Recovery and Survival Strategies for Patients Undergoing Hematopoietic Cell Transplantation
Date:12/10/2011

demonstrated recently by using a less aggressive, non-myeloablative preparative regimen, followed by an infusion of unmanipulated bone marrow and the post-transplant use of a common chemotherapy drug, cyclophosphamide (Cy), but relapse is relatively common, especially in those with high-risk myeloid malignancies. This study sought to determine whether it is possible to decrease the probability of relapse in these high-risk patients by using a myeloablative preparative regimen with PBSCs, instead of bone marrow, as the graft source.

Between January 2009 and March 2011, the investigators initiated a clinical trial enrolling 20 patients with high-risk blood cancers, including leukemia and both Hodgkin and non-Hodgkin lymphoma, undergoing haploidentical HCT. Participants were eligible for the trial if they were perceived to be at a high risk of relapse using a less aggressive preparative regimen following transplantation. Eleven patients (55%) had relapsed or refractory disease, while the remaining nine patients (45%) had standard-risk disease, the majority being leukemia patients in remission but associated with poor-risk features. After the administration of the myeloablative preparative regimen, patients underwent transplantation with PBSCs, followed by an immunosuppressive regimen of Cy (50mg/kg/day) on days three and four post transplant along with other supportive therapies.

After an average follow-up of 14 months, investigators reported an estimated one-year overall survival rate of 74 percent and a disease-free survival (DFS) rate of 51 percent for all patients; for standard risk patients, one year overall survival was 100 percent and DFS was 76 percent. Non-relapse mortality at 100 days and 12 months was 10 percent for all patients and zero for standard risk patients. The cumulative incidence of chronic GVHD at one year was 42 percent.

Non-infectious fever developed in 90 percent of patients within a median of 2.5 days of transplant and w
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SOURCE American Society of Hematology
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