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Lymphodepleting effects and safety of pentostatin for nonmyeloablative allogeneic stem-cell transplantation1

 

作者: Steven Pavletic,   R. Bociek,   James Foran,   Ronald Rubocki,   Charles Kuszynski,   James Wisecarver,   Lori Hatcher,   David Lucas,   John Byrd,   Michael Grever,   Shantaram Joshi,   Penny Hardiman,   Lynette Smith,   Timothy McGuire,   Philip Bierman,   Julie Vose,   James Armitage,   James Talmadge,  

 

期刊: Transplantation  (OVID Available online 2003)
卷期: Volume 76, issue 5  

页码: 877-881

 

ISSN:0041-1337

 

年代: 2003

 

出版商: OVID

 

数据来源: OVID

 

摘要:

Nonmyeloablative allogeneic stem-cell transplantation (alloNST) is the focus of investigations searching for less-toxic transplantation regimens. We report studies on the kinetics of lymphodepletion and safety of pentostatin (PT) conditioning in alloNST. Patients with hematologic malignancy received mobilized blood from human leukocyte antigen-matched related (n=4) or unrelated (n=8) donors. PT 4 mg/m2was administered on days −21, −20, and −19 and 200 cGy of total-body irradiation was administered on day −1, followed by cyclosporine A and mycophenolate mofetil. Mononuclear cell adenosine deaminase after PT was inhibited 84%. The absolute CD3+cells decreased significantly by day −7 (49%) and CD19+cells declined 92% by day −1. CD4+cells were depressed more than CD8+cells. Neutrophils and monocytes were minimally affected by PT. Median posttransplant peripheral blood chimerism on day 70 showed 95% donor leukocytes and 82.5% donor CD3 lymphocytes. PT demonstrated lymphodepleting effects and promising safety, supporting alloNST as early as 7 days after initiation of PT.

 

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