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More on the mini allo SCT

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Reduced-Intensity Regimens in Allogeneic

Stem-Cell Transplantation for Non-Hodgkin

Lymphoma and Chronic Lymphocytic Leukemia

http://asheducationbook.hematologylibrary.org/cgi/reprint/2006/1/390.pdf

Summary:

Summary: The current data collectively suggest that addition of anti-CD20

monoclonal antibodies significantly improves the outcome of autologous SCT

in patients with NHL who have chemosensitive disease (Table 3). It is

recommended for patients with DLCL or Follicular Lymphoma undergoing their

first relapse and MCL during first remission, but not in patients with CLL.

(My note: But not necessarily the standard of care for any histology)

A significant Graft versus Lymphoma effect can be achieved clinically

through the use of nonmyeloablative transplantation in patients with

chemosensitive advanced disease. Yet the applicability of nonmyeloablative

SCT appears dependent on disease histologic type, individual patient, and

disease characteristics.

The current data suggest an increased risk of relapse with the use of

alemtuzumab.

Randomized studies may allow the comparison of various nonmyeloablative

transplantation strategies.

High-dose conditioning regimens should be considered for patients with

chemorefractory (resistant) disease who are young and have a good

performance status.

The field offers significant opportunity for clinical research, and we

strongly encourage participation in clinical trials whenever possible.

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