Stem cell transplant conditioning regimens

Conditioning is the treatment the patient undergoes immediately prior to a stem cell transplant. The purpose is to reduce the burden of residual disease; in allogeneic transplant recipients, it also acts as an immunosuppressant to prevent rejection of the graft. There are many different protocols using chemotherapy alone or in combination with total body irradiation (TBI). Unrelated transplants require immunosuppression with ALG or anti-T-cell monoclonal antibodies or total lymphoid Irradiation (TLI).

Examples are

AML-allo and autografts

• Cyclophosphamide 120mg/kg + 13.2Gy fractionated TBI or Cyclophosphamide 120mg/kg + busulfan 16 mg/kg.

ALL-Allo and autografts

• Cyclophosphamide 120mg/kg + 13.2Gy fractionated TBI or Etoposide 60mg/kg + 14.4Gy fractionated TBI.

Non-myeloablative allografts

• Campath-1H 100mg + fludarabine 150mg/m2 + melphalan 140mg/m2. NHL-autografts

• BEAM (BCNU, etoposide, ara-C and melphalan; p612).

Myeloma-autografts

• High dose melphalan 200mg/m2.

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