It weakens the patient's own immune system so that the donor cells are not rejected. Conditioning treatment is given to destroy any remaining cancer cells in the body. The Trish Greene Back to School ProgramĪllogeneic stem cell transplantation involves the use of stem cells from someone other than the patient. The donated stem cells can come from either a person related or not related to the patient.īefore beginning an allogenic SCT, the patient receives a conditioning treatment that consists of either chemotherapy or radiation.The vast majority of non-myeloablative transplants have used donor cells derived from the peripheral blood (peripheral blood stem cells), but bone marrow cells can also be used. It is feared that the non-myeloablative preparative therapy will not be sufficient to suppress the immune system of the patient failure of the new donor cells to grow would be the result. Transplants from partially matched related donors have only rarely been attempted. Most of the non-myeloablative transplants performed so far have used HLA-identical siblings or well-matched unrelated donors. Thus, such cancers would not be good candidates for non-myeloablative transplants. In addition, not all cancers that can be treated with allogeneic transplants have shown clear graft-versus-tumor effects. Therefore, rapidly growing cancers, such as aggressive malignant lymphoma or acute leukemia in relapse, often do not respond to non-myeloablative transplants. The chemotherapy of the preparative regimen is usually not active enough to suppress the cancer by itself. Non-myeloablative transplants rely mainly on the graft versus tumor effect. Thus, patients in their sixties or patients with impaired heart, kidney or lung function may still be candidates for non-myeloablative transplant. The less toxic nature of the chemotherapy used for non-myeloablative transplants allows this treatment to be utilized in patients who are not candidates for "conventional" allogeneic transplants. IBMT physicians often perform non-myeloablative transplants completely as an outpatient therapy. The direct side effects of the preparative regimen are clearly less. If a graft versus tumor effect could benefit such a patient, a non-myeloablative transplant may be the best therapy option.īecause they use less aggressive, less toxic chemotherapy and/or radiation, non-myeloablative transplants tend to be better tolerated by your body. Many patients who might benefit from an allogenic stem-cell transplant are not good candidates for a conventional allogeneic transplant, because their advanced age or abnormalities in one of their organ systems would not allow the use of the very toxic preparative chemotherapy and/or radiation. Is a non-myeloablative transplant a good choice for me? In other diseases the evidence is less convincing. In some diseases (chronic myelogenous leukemia, acute myelogenous leukemia, malignant lymphoma and renal cell cancer) there is strong evidence of this graft-versus-tumor effect. The new (donor) immune system growing inside the body of the patient, may recognize the cancer cells as "dangerous" or "foreign", and may attack them (graft-versus-tumor effect).The chemotherapy and/or radiation given prior to the transplant (preparative regimen or conditioning regimen) often destroys a lot of the cancer cells.Stem cell transplants with donor cells can fight cancer in two ways The non-myeloablative transplant aims just to suppress the patient's immune system sufficiently to allow engraftment of the donor cells. In the "conventional" allogeneic stem cell transplants, the goals of the preparative chemotherapy/radiation are to kill as many cancer cells as possible and to suppress the immune system of the patient to allow the donor cells to grow. Non-Myeloablative transplant, also called "mini-transplant," "transplant-lite," or "reduced intensity transplant," is a stem cell transplant from a donor (allogeneic) that uses a less aggressive combination of chemotherapy and/or radiation to prepare the patient for the transplant.
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