Bone Marrow Transplantation
“MINI” bone marrow transplants effective against haematologic malignancies
“Mini” transplants of bone marrow or peripheral blood stem cells defined as transplant without myeloablation could be the answer to a variety of haematologic malignancies. In mini transplantation, a relatively mild dose of chemotherapy and radiation is administered - ideally just enough to provide sufficient immunosuppression to enable engraftment of allogeneic bone marrow or stem cells. After transplantation, any remaining malignant blood cells would be recognized by the donor blood cells as foreign and would be destroyed in a graft-versus tumour effect.
Richard Champlin, MD of the university of Texas, MD Anderson Cancer Center in Houston restricted mini transplants to patients older than 55 years and those with comorbidities that made them ineligible for a conventional transplant. About half of the patients diagnosed with recurrent acute or chronic myeloid leukemia who responded to chemotherapy and were treated with Mini transplants had complete remissions lasting up to 4 years. In a similar trial in Israel, 19 patients with severe chronic myeloid leukemia underwent “mini” transplants and according to Shimon Slavin, MD of Hadassah Hospital Jerusalem, Israel, only a single patient experienced a relapse. A disease-free survival rate of 81% after 4 years was reported.
The success of the mini-transplants appears to depend on the specific diagnosis, disease severity, chemo-resistance, and the closeness of the donor cell match, among other variables. On the flip side, a resultant graft-versus-host disease could result, its effect ranging from the very mild to fatal.
- Copyright © 2021. Published by MOHAN Foundation
- Keywords: bone marrow, myeloablation, mini-transplantation, Richard Champlin