Abstract
Hematopoietic stem cell transplantation is an established treatment modality for malignant and non-malignant diseases. Prior to the infusion of allogeneic or autologous cells, patients usually receive radiation or chemotherapy. This “preparative” or ‘conditioning’ regimen provides treatment for the underlying disease and is expected to impair the recipients immune system and allow engraftment. The last decade witnessed a significant reduction in treatment-related mortality, in great part a result of less toxic preparative regimens and improvements in supportive care. Another important trend has been the incorporation of newer drugs to ‘classic’ conditioning regimens, as illustrated by the addition of rituximab to BEAM and other combinations. It is expected that this trend will continue leading to increased cure rates by incorporation of targeted therapies to hematopoietic transplant. The next decade will likely witness further integration of new preparative regimens with graft engineering, and pharmacologic, cellular and immunologic post transplant interventions. The design of creative clinical trials that will allow the critical evaluation of the role of these new approaches in transplantation will also be a major challenge to the transplant community in the years to come. In this article, we review newer transplant conditioning regimens and discuss their indications and future directions in this rapidly changing landscape.
Keywords: Hematopoietic stem cell transplantation, preparative regimens, conditioning, hematologic malignancies
Current Pharmaceutical Design
Title: Novel Preparative Regimens in Hematopoietic Stem Cell Transplantation
Volume: 14 Issue: 20
Author(s): Lazaros Lekakis, Leandro de Padua Silva and Marcos de Lima
Affiliation:
Keywords: Hematopoietic stem cell transplantation, preparative regimens, conditioning, hematologic malignancies
Abstract: Hematopoietic stem cell transplantation is an established treatment modality for malignant and non-malignant diseases. Prior to the infusion of allogeneic or autologous cells, patients usually receive radiation or chemotherapy. This “preparative” or ‘conditioning’ regimen provides treatment for the underlying disease and is expected to impair the recipients immune system and allow engraftment. The last decade witnessed a significant reduction in treatment-related mortality, in great part a result of less toxic preparative regimens and improvements in supportive care. Another important trend has been the incorporation of newer drugs to ‘classic’ conditioning regimens, as illustrated by the addition of rituximab to BEAM and other combinations. It is expected that this trend will continue leading to increased cure rates by incorporation of targeted therapies to hematopoietic transplant. The next decade will likely witness further integration of new preparative regimens with graft engineering, and pharmacologic, cellular and immunologic post transplant interventions. The design of creative clinical trials that will allow the critical evaluation of the role of these new approaches in transplantation will also be a major challenge to the transplant community in the years to come. In this article, we review newer transplant conditioning regimens and discuss their indications and future directions in this rapidly changing landscape.
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Cite this article as:
Lekakis Lazaros, Silva de Padua Leandro and de Lima Marcos, Novel Preparative Regimens in Hematopoietic Stem Cell Transplantation, Current Pharmaceutical Design 2008; 14 (20) . https://dx.doi.org/10.2174/138161208785061409
DOI https://dx.doi.org/10.2174/138161208785061409 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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