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HLA-Haploidentical Bone Marrow Transplantation for Hematologic Malignancies Using Nonmyeloablative Conditioning and High-Dose, Posttransplantation Cyclophosphamide

Open access
Luznik, Leo, O'Donnell, Paul V., Symons, Heather J., Chen, Allen R., Leffell, M. Susan, Zahurak, Marianna, Gooley, Ted A., Piantadosi, Steve, Kaup, Michele, Ambinder, Richard F., Huff, Carol Ann, Matsui, William, Bolaños-Meade, Javier, Borrello, Ivan, Powell, Jonathan D., Harrington, Elizabeth, Warnock, Sandy, Flowers, Mary, Brodsky, Robert A., Sandmaier, Brenda M., Storb, Rainer F., Jones, Richard J., Fuchs, Ephraim J.·2008·Biology of Blood and Marrow Transplantation

Abstract

We evaluated the safety and efficacy of high-dose, posttransplantation cyclophosphamide (Cy) to prevent graft rejection and graft-versus-host disease (GVHD) after outpatient nonmyeloablative conditioning and T cell-replete bone marrow transplantation from partially HLA-mismatched (haploidentical) related donors. Patients with advanced hematologic malignancies (n = 67) or paroxysmal nocturnal hemoglobinuria (n = 1) received Cy 50 mg/kg i.v. on day 3 (n = 28) or on days 3 and 4 (n = 40) after transplantation. The median times to neutrophil (>500/microL) and platelet recovery (>20,000/microL) were 15 and 24 days, respectively. Graft failure occurred in 9 of 66 (13%) evaluable patients, and was fatal in 1. The cumulative incidences of grades II-IV and grades III-IV acute (aGVHD) by day 200 were 34% and 6%, respectively. There was a trend toward a lower risk of extensive chronic GVHD (cGVHD) among recipients of 2 versus 1 dose of posttransplantation Cy (P = .05), the only difference between these groups. The cumulative incidences of nonrelapse mortality (NRM) and relapse at 1 year were 15% and 51%, respectively. Actuarial overall survival (OS) and event-free survival (EFS) at 2 years after transplantation were 36% and 26%, respectively. Patients with lymphoid malignancies had an improved EFS compared to those with myelogenous malignancies (P = .02). Nonmyeloablative HLA-haploidentical BMT with posttransplantation Cy is associated with acceptable rates of fatal graft failure and severe aGVHD or cGVHD.

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Metadata

Authors
Luznik, L., O'Donnell, P. V., Symons, H. J., Chen, A. R., Leffell, M. S., Zahurak, M., Gooley, T. A., Piantadosi, S., Kaup, M., Ambinder, R. F., Huff, C. A., Matsui, W., Bolaños-Meade, J., Borrello, I., Powell, J. D., Harrington, E., Warnock, S., Flowers, M., Brodsky, R. A., Sandmaier, B. M., Storb, R. F., Jones, R. J., & Fuchs, E. J.
Venue
Biology of Blood and Marrow Transplantation
Publisher
Elsevier BV
Published
2008-06
Volume
14
Issue
6
Pages
641-650
ISSN
1083-8791 (ISSN-L)
OpenAlex
W2039334806
Cited by
1,938
References
5
FWCI
16.60
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: HLA-Haploidentical Bone Marrow Transplantation for Hematologic Malignancies Using Nonmyeloablative Conditioning and High-Dose, Posttransplantation Cyclophosphamide. https://app.cochat.ai/papers/10.1016/j.bbmt.2008.03.005
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Luznik, L., O'Donnell, P. V., Symons, H. J., Chen, A. R., Leffell, M. S., Zahurak, M., Gooley, T. A., Piantadosi, S., Kaup, M., Ambinder, R. F., Huff, C. A., Matsui, W., Bolaños-Meade, J., Borrello, I., Powell, J. D., Harrington, E., Warnock, S., Flowers, M., Brodsky, R. A., . . . Fuchs, E. J. (2008). HLA-Haploidentical Bone Marrow Transplantation for Hematologic Malignancies Using Nonmyeloablative Conditioning and High-Dose, Posttransplantation Cyclophosphamide. Biology of Blood and Marrow Transplantation. https://doi.org/10.1016/j.bbmt.2008.03.005

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.