Promising Role of Reduced-Toxicity Hematopoietic Stem Cell Transplantation (PART-I)

摘要: Allogeneic hematopoietic stem cell transplantation (HSCT) remains a potential curative option for many patients with hematological malignancies (HM). However, the high rate of transplantation-related mortality (TRM) restricted use standard myeloablative HSCT to minority young and fit patients. Over past few years, it has become evident that alloreactivity immunocompetent donor cells mediated anti-malignancy effects independent action dose chemoradiotherapy. The reduced intensity conditioning (RIC) regimens allowed graft-versus-malignancy (GvM) effect be exploited in who were previously ineligible on grounds age comorbidity. Retrospective analysis showed RIC been associated lower TRM but higher relapse leading similar intermediate term overall progression-free survivals when compared HSCT. long antitumor this approach is less well established. Prospective studies are ongoing define which might most benefit from toxicity transplant (RT-SCT) protocols suitable different types HM. advent RT-SCT permits delivery potentially GvM majority HM whose outcome conventional chemotherapy would dismal. Remaining challenges include development effective strategies reduce rates by augmenting without increasing toxicity.