Hematopoietic stem cell allografts using a non-myeloablative conditioning regimen can be safely performed on an outpatient basis : report of four cases

• Published in: Bone marrow transplantation (Basingstoke) Vol. 25; no. 2; pp. 131 - 133
• Main Authors: GOMEZ-ALMAGUER, D, RUIZ-ARGÜELLES, G. J, RUIZ-ARGÜELLES, A, GONZALEZ-LLANO, O, CANTU, O. E, HERNANDEZ, N. E
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.01.2000
• Subjects: Acute myeloid leukemia; Adolescent; Adult; Allografts; Ambulatory Care - economics; Antineoplastic agents; beta-Thalassemia - blood; beta-Thalassemia - complications; beta-Thalassemia - therapy; Biological and medical sciences; Biopsy; Blood Component Transfusion; Blood transfusion; Bone marrow; Bone marrow transplantation; Chimerism; Chronic myeloid leukemia; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Conditioning; Erythrocytes; Female; Fludarabine; Graft vs Host Disease - etiology; Graft-versus-host reaction; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - economics; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic stem cells; Humans; Immunosuppressive agents; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Leukemia; Leukemia, Myeloid - blood; Leukemia, Myeloid - complications; Leukemia, Myeloid - therapy; Leukocyte Count - drug effects; Leukocytes (granulocytic); Leukocytes (neutrophilic); Male; Medical sciences; Middle Aged; Patients; Peripheral blood; Pharmacology. Drug treatments; Recovery time; Remission Induction; Stem cell transplantation; Stem cells; Survival Rate; Thalassemia; Thrombocytopenia; Thrombocytopenia - etiology; Transfusion; Transplantation; Transplantation Conditioning - adverse effects; Transplantation Conditioning - economics; Transplantation Conditioning - methods; Transplants; Transplants & implants; Treatment Outcome; Vidarabine - adverse effects; Vidarabine - analogs & derivatives; Vidarabine - therapeutic use; Antineoplastic agent; Human; Hemoglobinopathy; Purine nucleotide; Stem cell; Hematopoietic cell; Homograft; Thalassemia; Malignant hemopathy; Hemopathy; Genetic disease; Myeloproliferative syndrome; Chronic; Hemolytic anemia; Fludarabine; Treatment; Antimetabolic; Chronic myelocytic leukemia; Graft; Combined treatment; Immunosuppressive agent; Myelopoiesis; Pretreatment; Acute myelocytic leukemia
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1702100

Using a non-myeloablative, immunosuppressive, fludarabine-based conditioning regimen, we performed allogeneic peripheral blood stem cell transplants totally on an outpatient basis in four patients (two with chronic myelogenous leukemia, one with acute myelogenous leukemia and one with thalassemia major). The median granulocyte recovery time to 0.5 x 109/l was 10 days and the lowest absolute neutrophil count was 0.064 x 109/l; only one patient developed thrombocytopenia below 20 x 109/l. No patient required red blood cell transfusions and one was given a single prophylactic platelet transfusion. All patients are alive at 210-390 (median 285) days and have definite evidence of chimerism; one developed biopsy-proven GVHD on day 50, with a limited cutaneous rash. The procedure is less costly than its counterpart using myeloablative conditioning regimens and may represent another approach in the management of patients requiring an allogeneic stem cell transplant. Bone Marrow Transplantation (2000) 25, 131-133.