Reduced-intensity allogeneic stem cell transplantation (sometimes called mini-transplant or nonmyeloablative transplant), like a standard allogeneic stem cell transplantation, uses stem cells from a donor, but the conditioning treatment contains lower, less toxic doses of chemotherapy and radiation. This type of SCT may be an option for certain patients who are older or who are otherwise not healthy enough or strong enough to undergo standard allogeneic SCT.
The success of reduced-intensity SCT depends on the graft-versus-tumor (GVT) effect of the donor stem cells rather than on high-dose treatments to kill the cancer cells. The goal is to have the donor stem cells take up residence in the recipient’s marrow and produce white blood cells that will attack the patient’s remaining cancerous blood cells.
Research shows that reduced-intensity allogeneic SCT may be effective in treating certain patients with chronic myeloid leukemia (CML); acute myeloid leukemia (AML); non-Hodgkin lymphoma (NHL); chronic lymphocytic leukemia (CLL); or myelodysplastic syndromes (MDS).
Reduced-intensity allogeneic transplantations carry many of the same risks as standard allogeneic transplantations. One risk is that the patient’s body may reject the donated stem cells before they are able to engraft in the bone marrow. The patient’s immune cells may see the donor’s cells as foreign and destroy them before the donor stem cells can engraft (grow and make new blood cells in the patients body).
Another risk is that the immune cells from the donor (the graft) may attack healthy cells in the patient’s body (host). This is called “graft-versus-host disease” (GVHD).
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