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Cited by 276

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Reduced-intensity conditioning significantly improves survival of patients with hemophagocytic lymphohistiocytosis undergoing allogeneic hematopoietic cell transplantation

Marsh, Rebecca A., Vaughn, Gretchen, Kim, Mi-Ok, Li, Dandan, Jodele, Sonata, Joshi, Sarita, Mehta, Parinda A., Davies, Stella M., Jordan, Michael B., Bleesing, Jack J., Filipovich, Alexandra H.·2010·Blood

Abstract

Recent experience suggests that reduced-intensity conditioning (RIC) regimens can improve the outcomes of patients with hemophagocytic lymphohistiocytosis (HLH) undergoing allogeneic hematopoietic cell transplantation (HCT). However, studies directly comparing RIC to myeloablative conditioning (MAC) regimens are lacking. Forty patients with HLH underwent allogeneic HCT between 2003-2009 at Cincinnati Children's Hospital. Fourteen patients received MAC consisting of busulfan, cyclophosphamide, and antithymocyte globulin plus or minus etoposide. Twenty-six patients received RIC consisting of fludarabine, melphalan, and alemtuzumab. All patients engrafted. Acute graft-versus-host disease grades II to III occurred in 14% of MAC patients and 8% of RIC patients (P = .3171). Posttransplantation mixed donor/recipient chimerism developed in 18% of MAC patients and 65% of RIC patients (P = .0110). The majority of patients with mixed chimerism received intervention with reduction of immune suppression plus or minus donor lymphocyte infusion or stem cell boost, which stabilized or increased donor contribution to hematopoiesis and prevented relapse of HLH in all but 1 patient. Grade II to III graft-versus-host disease occurred in 5 of 14 RIC patients after donor lymphocyte infusion. The overall estimated 3-year survival after HCT was 43% (confidence interval = ± 26%) for MAC patients and 92% (confidence interval = ± 11%) for RIC patients (P = .0001). We conclude that RIC significantly improves the outcome of patients with HLH undergoing allogeneic HCT.

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Metadata

Authors
Marsh, R. A., Vaughn, G., Kim, M.-O., Li, D., Jodele, S., Joshi, S., Mehta, P. A., Davies, S. M., Jordan, M. B., Bleesing, J. J., & Filipovich, A. H.
Venue
Blood
Published
2010-12-23
Volume
116
Issue
26
Pages
5824-5831
ISSN
  • 0006-4971 (ISSN-L)
  • 1528-0020
OpenAlex
W2022439256
Cited by
276
References
17
FWCI
9.34
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Reduced-intensity conditioning significantly improves survival of patients with hemophagocytic lymphohistiocytosis undergoing allogeneic hematopoietic cell transplantation. https://app.cochat.ai/papers/10.1182/blood-2010-04-282392
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Marsh, R. A., Vaughn, G., Kim, M.-O., Li, D., Jodele, S., Joshi, S., Mehta, P. A., Davies, S. M., Jordan, M. B., Bleesing, J. J., & Filipovich, A. H. (2010). Reduced-intensity conditioning significantly improves survival of patients with hemophagocytic lymphohistiocytosis undergoing allogeneic hematopoietic cell transplantation. Blood. https://doi.org/10.1182/blood-2010-04-282392

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