IMR Press / FBL / Volume 6 / Issue 5 / DOI: 10.2741/maris

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Nonmyeloablative hematopoietic stem cell transplantation: transplantation for the 21st century
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1 Fred Hutchinson Cancer Research Center, University of Washington, Seattle 98109-1024, USA
2 University of Washington, Seattle, WA, USA
3 Veterans Administration Medical Center, Seattle, WA, USA
4 Stanford University, Stanford, CA, USA
5 University of Leipzig, Leipzig, Germany

Academic Editor: Michael Trigg

Front. Biosci. (Landmark Ed) 2001, 6(5), 13–16;
Published: 1 August 2001

Conventional approaches to allogeneic stem cell transplantation have used toxic high-dose conditioning therapy to achieve allogeneic engraftment and control of underlying disease. For engraftment purposes, preclinical studies and clinical observations have shown that conditioning regimens can be markedly reduced in intensity, resulting in reduced treatment toxicities. Preclinical canine studies demonstrated that the use of potent pre- and postgrafting immunosuppression allows for reduction in conditioning regimens while facilitating development of stable mixed chimerism. If attenuated conditioning regimens can be successfully translated to human stem cell transplantation, an improved safety profile will allow potentially curative treatment to a more representative patient profile not currently offered such therapy. Mixed chimerism could prove curative of disease phenotype of various nonmalignant disturbances of the hematopoietic and immune systems. For patients with hematopoietic malignancy, spontaneous conversion to full donor hematopoeisis after stem cell transplant may prove curative by virtue of graft versus host reactions directed against the malignancy, however infusion of additional donor lymphocytes may be needed to treat persistent disease.

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