Outpatient allografting using non-myeloablative conditioning: the Mexican experience

Cantú-Rodrı́guez, Olga Graciela; Jaime‐Pérez, José Carlos; Gutiérrez-Aguirre, César Homero; González-Llano, Óscar; Mancı́as-Guerra, Consuelo; Tarín‐Arzaga, Luz; Ruíz-Delgado, Guillermo J.; Sandoval-Villa, C C; Marfil-Rivera, J; Morales-Toquero, Amelia; Ruíz‐Argüelles, Guillermo J.; Gómez‐Almaguer, David

doi:10.1038/sj.bmt.1705700

Cited by 25 publications

(14 citation statements)

References 19 publications

(25 reference statements)

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“…In our experience in 193 patients, only 22% were hospitalized, mainly because the development of fever or mucositis. Normal complete blood count and Karnofsky >70% are values that reliably predict whether an outpatient stem cell transplant can be successfully completed [39]. Interestingly, we also found that the long-term disease free survival of the patients that were allografted on an outpatients basis was significantly better thatn that of those who were admitted to the hospital [39].…”

Section: ) Outpatient Conductionsupporting

confidence: 57%

Making Allogeneic Bone Marrow Transplantation Available to Patients in Developing Countries: The Mexican Experience

Ruíz‐Argüelles¹,

Gómez‐Almaguer²

2008

TOHJ

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Non-myeloablative allogeneic stem cell transplantation (NST) has been one of the most exciting developments in the treatment of hematologic malignancies in the last years. Since 1999, we have chosen to employ in México a regimen to conduct NST, introducing some changes with the main goal of decreasing the cost of the procedure and in turn, making it available to a larger number of patients in developing countries. Using this method we have done over 400 allografts in Latin American patients with different both malignant and non-malignant diseases: Chronic myelogenous leukemia, acute myelogenous leukemia, acute lymphoblastic leukemia, myelodysplasia, thalassemia major, relapsed Hodgkin´s disease, Blackfan-Diamond syndrome, adrenoleukodystrophy, Hunter´s syndrome, aplastic anemia and several solid tumors. In the whole group, the median granulocyte recovery time to 0.5 x 10 9 /L was 13 days, whereas the median platelet recovery time to 20 x 10 9 /L was 12 days. Around one third of the patients did not need red blood cell transfusions and also one third did not need platelet transfusions. In more than 70% of cases the procedure could be completed totally on an outpatient basis. The follow up time of the patients ranges between 30 and 2000 days. Approximately 50% of the allografted individuals have developed acute graft versus host disease (GVHD), whereas around 30% developed chronic GVHD. The median post-allograft overall survival (SV) has not been reached and the 2000 day overall SV is 54%, the 100-day mortality being 16%. In the whole group of patients, the median cost of each NST was 18 000 USD, a figure which contrasts with that informed from developing countries. More than 95% of the patients who were allografted in México and Latin America using this method could not have afforded the cost of a conventional or more expensive stem cell transplant; accordingly, this procedure has enabled doctors in México and Latin America to offer this therapeutic approach to a larger number of individuals.

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Section: ) Outpatient Conductionsupporting

confidence: 57%

Making Allogeneic Bone Marrow Transplantation Available to Patients in Developing Countries: The Mexican Experience

Ruíz‐Argüelles¹,

Gómez‐Almaguer²

2008

TOHJ

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“…В последую-щем появился вариант режима FLAMSA, в котором ТОТ было заменено бусульфаном, что привело к улуч-шению результатов: в группе из 12 пациентов, кото-рые его получили, не отмечено рецидивов [25]. Как показали мексиканские исследователи (O. Cantú-Rodríguez et al, 2007), назначение РИК (бусульфан, циклофосфамид и флударабин) возмож-но в амбулаторном режиме, при этом из 132 пациентов 103 (78 %) смогли завершить алло-ТГСК вне стацио-нара, а оставшиеся 29 (22 %) больных были помеще-ны в госпиталь из-за лихорадки, мукозита, острой РТПХ или других осложнений [26]. Кроме того, РИК способствует снижению частоты и тяжести РТПХ (n = 301; O. Cantú-Rodríguez et al, 2011) [27].…”

Section: тенденции в режимах кондиционирования при аллогенной трансплunclassified

Allogeneic transplantation of hematopoietic stem cells: Perspectives and alternatives, own experience

Петрович¹,

Рукавицын²

2017

Ross. ž. det. gematol. onkol.

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“…For economic reasons, RIC was used in all patients [4,5,6,7]. A Karnofsky score of 100% was required to conduct the allograft.…”

Section: Methodsmentioning

confidence: 99%

“…Subcutaneous G-CSF (10 μg/kg/day) was given to the sibling donors on days -5 to +2, and 1-3 peripheral blood stem cell apheresis procedures were planned for days 0, +1 and +2 using the Spin-Nebraska protocol [8]. The nonablative conditioning used in this study consisted of the following [4,5,6,7]: oral busulfan, 4 mg/kg, given on days -6 and -5; i.v. cyclophosphamide, 350 mg/m 2 , on days -4, -3 and -2; i.v.…”

Section: Methodsmentioning

confidence: 99%

“…fludarabine in the conditioning of allo-SCT [1,2,3]. For over 15 years we have been conducting allo-SCT in México using a reduced-intensity conditioning (RIC) regimen which employs fludarabine, cyclophosphamide and busulfan - the so-called ‘Mexican-conditioning regimen' [4,5,6,7]. Between October 1998 and December 2007, the RIC allo-SCTs were conducted using i.v.…”

Section: Introductionmentioning

confidence: 99%

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Oral versus<b> </b>Intravenous Fludarabine as Part of a Reduced-Intensity Conditioning for Allogeneic Stem Cell Transplantation

Velázquez-Sánchez-de-Cima

Zamora-Ortiz²,

Hernández-Reyes³

et al. 2014

Acta Haematol

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Background: In 2003, oral fludarabine was introduced in the USA for the treatment of patients with hematologic malignancies as an alternative to its intravenous (i.v.) formulation; in 2008, it was introduced in México while the i.v. formulation was withdrawn. Accordingly, i.v. fludarabine had to be replaced by oral fludarabine as part of the conditioning regimen employed to conduct allogeneic stem cell transplantation in México. Methods: Nonrandomized retrospective analysis of 55 patients conditioned with oral fludarabine compared with 113 patients conditioned with the i.v. formulation. In addition to fludarabine, the conditioning regimen included oral busulfan and i.v. cyclophosphamide. Donors were HLA-matched siblings. Results: The clinical features of the two groups were comparable. There were no statistical differences in time to neutrophil engraftment, time to platelet engraftment, acute graft versus host disease rate and nonrelapse mortality at day 100. The overall survival of patients allografted with oral fludarabine was better than those allografted with i.v. fludarabine: 62 and 33% at 67 months, respectively (p = 0.0006). Discussion: Oral fludarabine can replace its i.v. formulation as part of reduced-intensity conditioning regimens with no deleterious effect on any of the early transplantation outcomes.

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Outpatient allografting using non-myeloablative conditioning: the Mexican experience

Cited by 25 publications

References 19 publications

Making Allogeneic Bone Marrow Transplantation Available to Patients in Developing Countries: The Mexican Experience

Making Allogeneic Bone Marrow Transplantation Available to Patients in Developing Countries: The Mexican Experience

Allogeneic transplantation of hematopoietic stem cells: Perspectives and alternatives, own experience

Oral versus<b> </b>Intravenous Fludarabine as Part of a Reduced-Intensity Conditioning for Allogeneic Stem Cell Transplantation

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