TY - JOUR
T1 - Allogeneic hematopoietic transplantation as adoptive immunotherapy
T2 - Induction of graft-versus-malignancy as primary therapy
AU - Champlin, R.
AU - Khouri, I.
AU - Kornblau, S.
AU - Marini, F.
AU - Anderlini, P.
AU - Ueno, N. T.
AU - Molldrem, J.
AU - Giralt, S.
PY - 1999
Y1 - 1999
N2 - An immune-mediated graft-versus-malignancy effect is important to prevent relapse after allogeneic bone marrow transplant for a range of hematologic malignancies and potentially some solid tumors. Graft-versus- leukemia (GVL) effects as seen in response to donor lymphocyte infusions have been most prominent against indolent malignancies including chronic myelogenous leukemia, chronic lymphocytic leukemia, and low-grade lymphoma. Acute myelogenous leukemia and multiple myeloma may also respond. An alternative strategy for allogeneic transplantation is to avoid the toxicity of high-dose chemoradiotherapy and use a relatively nontoxic, nonablative preparative regimen to achieve engraftment, allowing subsequent infusion of additional donor lymphocytes to mediate GVL. Fludarabine-based nonablative chemotherapy agents, using standard dose combinations, produce moderate myelosuppression but are sufficiently immunosuppressive to allow engraftment of an allogeneic hematopoietic transplant and generation of graft-versus- malignancy effects.
AB - An immune-mediated graft-versus-malignancy effect is important to prevent relapse after allogeneic bone marrow transplant for a range of hematologic malignancies and potentially some solid tumors. Graft-versus- leukemia (GVL) effects as seen in response to donor lymphocyte infusions have been most prominent against indolent malignancies including chronic myelogenous leukemia, chronic lymphocytic leukemia, and low-grade lymphoma. Acute myelogenous leukemia and multiple myeloma may also respond. An alternative strategy for allogeneic transplantation is to avoid the toxicity of high-dose chemoradiotherapy and use a relatively nontoxic, nonablative preparative regimen to achieve engraftment, allowing subsequent infusion of additional donor lymphocytes to mediate GVL. Fludarabine-based nonablative chemotherapy agents, using standard dose combinations, produce moderate myelosuppression but are sufficiently immunosuppressive to allow engraftment of an allogeneic hematopoietic transplant and generation of graft-versus- malignancy effects.
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U2 - 10.1016/S0889-8588(05)70108-8
DO - 10.1016/S0889-8588(05)70108-8
M3 - Article
C2 - 10553260
AN - SCOPUS:0032857134
SN - 0889-8588
VL - 13
SP - 1041
EP - 1057
JO - Hematology/Oncology Clinics of North America
JF - Hematology/Oncology Clinics of North America
IS - 5
ER -