Reinventing bone marrow transplantation: reducing toxicity using nonmyeloablative, preparative regimens and induction of graft-versus-malignancy. Review uri icon

Overview

abstract

  • Bone marrow transplantation was initially developed as a means to deliver supralethal doses of chemotherapy and radiation for treatment of malignancies. Myelosuppression is the dose-limiting toxicity for many chemotherapy drugs and whole-body radiation. Many malignancies exhibit a steep dose-response relationship to chemotherapy or radiotherapy. Bone marrow transplantation allows escalation of doses beyond those levels which produce severe bone marrow toxicity. Doses of many agents, particularly alkylating agents and whole body radiation, can be increased three- to fivefold above their conventional maximally tolerated dose. Marrow transplantation was considered a supportive care modality to restore hematopoiesis. It has become clear, however, that the high dose therapy does not eradicate the malignancy in many patients, and that the therapeutic benefit of allogeneic marrow transplantation is largely related to an associated immune-mediated graft-versus-malignancy effect.

publication date

  • March 1, 1999

Research

keywords

  • Antineoplastic Agents
  • Bone Marrow Transplantation
  • Graft vs Tumor Effect

Identity

Scopus Document Identifier

  • 0032992942

Digital Object Identifier (DOI)

  • 10.1097/00001622-199903000-00003

PubMed ID

  • 10188072

Additional Document Info

volume

  • 11

issue

  • 2