'Mini-allografts' for haematological malignancies: An alternative to conventional myeloablative marrow transplantation

Abstract

Background: Considerable morbidity and mortality are consequences of the myeloablative chemoradiotherapy utilised in conventional allogeneic marrow transplantation. This has generally restricted such potentially curative treatment to patients <50-55 years with normal organ function. Recent studies suggest that purine-analogue based nonmyeloablative regimens are sufficiently immunosuppressive to facilitate allogeneic donor cell engraftment. Aim: To review the outcome of HLA-compatible sibling allogeneic peripheral blood progenitor cell (PBPC) transplants using fludarabine-based conditioning in patients ineligible for a conventional transplant, with emphasis on engraftment, graft vs host disea..