2005, Number 4
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Med Sur 2005; 12 (4)
The “Mexican method” to conduct allogeneic bone marrow transplantation
Ruiz-Argüelles GJ, Suárez-González L, Gómez-Almaguer D, Ruiz-Delgado GJ
Language: Spanish
References: 58
Page: 503-211
PDF size: 86.46 Kb.
ABSTRACT
It is clear now that: a) For the successful engraftment of allogeneic HSC bone marrow ablation of the recipient is not required, b) HSC create their own space through graft versus host reactions, c) several malignancies can be eradicated by the graft versus tumor effect, d) HSC allografting can be conducted on an outpatient basis, e) HSC allografting can be done in aged or debilitated individuals, f) HSC allografting can be achieved without transfusion of blood products and g) the costs of the allografting procedures can be substantially diminished. The use of non-myeloablative conditioning for stem cell allografting has been the main reason to brake these dogmata: Using the “Mexican” non-ablative conditioning regimen, we have allografted over 300 individuals in five different Latin American countries. With a median cost of 18,000 US dollars, we have allografted individuals with both malignant and benign hematological diseases: The best results have been obtained in chronic myelogenous leukemia in chronic phase (92% survival –SV- at 750 days), whereas the worse results were obtained in relapsed acute lymphoblastic leukemia (22% SV at 1,600 days), with intermediate results for aplastic anemia (91% SV at 1,500 days) and acute myelogenos leukemia (66% SV at 860 days). Despite the fact that HSC allografting with reduced intensity conditioning may be related with several disadvantages such as mixed chimerism and relapse of the malignancy, braking these dogmata has resulted in availability of HSC allografting to a larger number of individuals worldwide, thus offering true curative therapeutic options to patients who otherwise would not qualify to be given these opportunities.
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