Biology of Blood and Marrow Transplantation
Volume 16, Issue 3 , Pages 384-394 , March 2010

Low-Dose Total Body Irradiation and Fludarabine Conditioning for HLA Class I-Mismatched Donor Stem Cell Transplantation and Immunologic Recovery in Patients with Hematologic Malignancies: A Multicenter Trial

  • Hirohisa Nakamae

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • ,
  • Barry E. Storer

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
  • ,
  • Rainer Storb

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
  • ,
  • Jan Storek

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Calgary, Calgary, Alberta, Canada
  • ,
  • Thomas R. Chauncey

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
    • Veterans Affairs Puget Sound Health Care System, Seattle, Washington
  • ,
  • Michael A. Pulsipher

      Affiliations

    • University of Utah, Salt Lake City, Utah
  • ,
  • Finn B. Petersen

      Affiliations

    • Intermountain Blood and Marrow Transplant Program, Salt Lake City, Utah
  • ,
  • James C. Wade

      Affiliations

    • Medical College of Wisconsin, Milwaukee, Wisconsin
  • ,
  • Michael B. Maris

      Affiliations

    • Rocky Mountain Blood & Marrow Transplantation, Denver, Colorado
  • ,
  • Benedetto Bruno

      Affiliations

    • University of Torino, Torino, Italy
  • ,
  • Jens Panse

      Affiliations

    • University of Hamburg, Hamburg, Germany
  • ,
  • Effie Petersdorf

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
  • ,
  • Ann Woolfrey

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
  • ,
  • David G. Maloney

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
  • ,
  • Brenda M. Sandmaier

      Affiliations

    • Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
    • University of Washington School of Medicine, Seattle, Washington
    • Corresponding Author InformationCorrespondence and reprint requests: Brenda M. Sandmaier, MD, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, Mail Stop D1-100, PO Box 19024, Seattle, WA 98109-1024.

Received 22 September 2009 ,Accepted 3 November 2009.

  • Image Result

    Cumulative incidences of grade II, III, and IV aGVHD (A) and clinical, extensive cGVHD (B).

    Cumulative incidences of grade II, III, and IV aGVHD (A) and clinical, extensive cGVHD (B).

  • Image Result

    Kaplan-Meier product estimates of NRM and relapse (A), overall survival and progression-free survival (B), and overall survival as stratified by HCT-CI score (C).

    Kaplan-Meier product estimates of NRM and relapse (A), overall survival and progression-free survival (B), and overall survival as stratified by HCT-CI score (C).

  • Image Result

    Recovery of lymphocyte subsets. Recovery of NK, B cells, dendritic cell precursors, CD4+ and CD8+ T cells after transplantation (A). Recovery of naive, memory/effector, CD28+ or CD28−, CD4+ and CD8+ T

    Recovery of lymphocyte subsets. Recovery of NK, B cells, dendritic cell precursors, CD4+ and CD8+ T cells after transplantation (A). Recovery of naive, memory/effector, CD28+ or CD28−, CD4+ and CD8+ T cells after transplantation (B). The y-axis shows the number of cells per microliter of blood. Patient medians (diamonds) and 25th-75th percentiles (error bars) are displayed. Normal medians (of 104 normal adults) are indicated by the dashed horizontal lines; the thick horizontal lines denote the normal 10th-90th percentiles. Pretransplantation studies are arbitrarily shown as performed using blood collected at 1-month pretransplantation, despite the fact that blood was drawn at any time between 1 month pretransplantation and the morning of starting conditioning. Day 0 studies were performed using blood drawn immediately before graft infusion. Nine patient blood samples were analyzed before transplantation, 7 were analyzed on day 0, 6 were analyzed at 1 month posttransplantation, 8 were analyzed at 3 months posttransplantation, 6 were analyzed at 6 months posttransplantation, and 5 were analyzed at 12 months posttransplantation.

  • Image Result
    Recovery of lymphocyte subsets. Recovery of NK, B cells, dendritic cell precursors, CD4+ and CD8+ T cells after transplantation (A). Recovery of naive, memory/effector, CD28+ or CD28−, CD4+ and CD8+ T

    Recovery of lymphocyte subsets. Recovery of NK, B cells, dendritic cell precursors, CD4+ and CD8+ T cells after transplantation (A). Recovery of naive, memory/effector, CD28+ or CD28−, CD4+ and CD8+ T cells after transplantation (B). The y-axis shows the number of cells per microliter of blood. Patient medians (diamonds) and 25th-75th percentiles (error bars) are displayed. Normal medians (of 104 normal adults) are indicated by the dashed horizontal lines; the thick horizontal lines denote the normal 10th-90th percentiles. Pretransplantation studies are arbitrarily shown as performed using blood collected at 1-month pretransplantation, despite the fact that blood was drawn at any time between 1 month pretransplantation and the morning of starting conditioning. Day 0 studies were performed using blood drawn immediately before graft infusion. Nine patient blood samples were analyzed before transplantation, 7 were analyzed on day 0, 6 were analyzed at 1 month posttransplantation, 8 were analyzed at 3 months posttransplantation, 6 were analyzed at 6 months posttransplantation, and 5 were analyzed at 12 months posttransplantation.

 Financial disclosure: See Acknowlegments on page 392.

PII: S1083-8791(09)00521-7

doi: 10.1016/j.bbmt.2009.11.004

Biology of Blood and Marrow Transplantation
Volume 16, Issue 3 , Pages 384-394 , March 2010