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

S Fadilah S. Abdul Wahid, Md Pazil Aqilah

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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

Original languageEnglish
Pages (from-to)1254-1264
Number of pages11
JournalStem Cell Reviews and Reports
Volume8
Issue number4
DOIs
Publication statusPublished - Dec 2012

Fingerprint

Hematopoietic Stem Cell Transplantation
Transplants
Hematologic Neoplasms
Neoplasms
Stem Cells
Transplantation
Recurrence
Mortality
Chemoradiotherapy
Disease-Free Survival
Comorbidity
Tissue Donors
Prospective Studies
Drug Therapy

Keywords

  • Graft-versus-malignancy (GvM)
  • Myeloablative conditioning (MAC)
  • Nonmyeloablative (NMA) conditioning regimens
  • Reduced intensity conditioning (RIC)
  • Reduced-toxicity hematopoietic stem cells transplantation (RT-SCT)

ASJC Scopus subject areas

  • Cancer Research
  • Cell Biology

Cite this

Promising Role of Reduced-Toxicity Hematopoietic Stem Cell Transplantation (PART-I). / S. Abdul Wahid, S Fadilah; Aqilah, Md Pazil.

In: Stem Cell Reviews and Reports, Vol. 8, No. 4, 12.2012, p. 1254-1264.

Research output: Contribution to journalArticle

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