Stem cell transplants for patients with relapsed/refractory leukaemia


Autoria(s): KOLB, Hans-Jochem; SIMOES, Belinda; SCHMID, Christoph
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

19/10/2012

19/10/2012

2009

Resumo

Purpose of review Today the indication for allogeneic stem cell transplantation for a high-risk leukaemia in first remission is well defined by most centres. In patients with primary refractory leukaemia the indication is controversially discussed. Similarly patients with relapse and advanced disease have a poor prognosis with chemotherapy, but also with transplantation. Finally more elderly patients with comorbidities seek help from transplantation, most of them in advanced and otherwise refractory disease. The results are reviewed. Recent findings The role of alloimmunity in the control of leukaemia has been defined and pretransplant conditioning treatment could be reduced to less intensive protocols. Graft-versus-leukaemia reactions have been demonstrated with the transfusion of donor lymphocytes. Using nonmyeloablative regimens allogeneic stem cell transplantation could be offered to elderly patients, the majority of patients with acute myeloid leukaemia and myelodysplastic syndromes. The use of antibodies and radio-immunotherapy has improved the treatment of lymphoid malignancies. Cord blood transplants have shown improved results with double transplants. The superiority of maternal donors indicates a role of the donor`s immune repertoire. Summary Taking advantage of alloimmune reactions and reduced intensity conditioning allogeneic stem cell transplantation has become successful even in elderly and fragile patients. The combination of molecular monitoring, targeted therapy and transplantation as a form of immunotherapy may improve the results of leukaemia treatment further.

Identificador

CURRENT OPINION IN HEMATOLOGY, v.16, n.6, p.444-452, 2009

1065-6251

http://producao.usp.br/handle/BDPI/23940

10.1097/MOH.0b013e3283309647

http://dx.doi.org/10.1097/MOH.0b013e3283309647

Idioma(s)

eng

Publicador

LIPPINCOTT WILLIAMS & WILKINS

Relação

Current Opinion in Hematology

Direitos

restrictedAccess

Copyright LIPPINCOTT WILLIAMS & WILKINS

Palavras-Chave #graft-versus-leukaemia #leukaemia #relapse #stem cell transplantation #ACUTE MYELOID-LEUKEMIA #BONE-MARROW-TRANSPLANTATION #ACUTE LYMPHOBLASTIC-LEUKEMIA #GRAFT-VERSUS-LEUKEMIA #CORD BLOOD TRANSPLANTATION #ACUTE MYELOGENOUS LEUKEMIA #TOTAL-BODY IRRADIATION #INTENSITY CONDITIONING REGIMEN #ACUTE LYMPHOCYTIC-LEUKEMIA #DOSE CYTOSINE-ARABINOSIDE #Hematology
Tipo

article

original article

publishedVersion