John Libbey Eurotext

Hématologie

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Reduced toxicity conditionning Volume 19, issue 3, Mai-Juin 2013

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Author
Département d’oncohématologie, centre de recherche en cancérologie de Marseille, université Aix-Marseille, Institut Paoli Calmettes, Marseille, France

The use of reduced intensity/non-myeloablative conditioning regimens prior to allogeneic stem cell transplantation has dramatically increased over the 15 last years. Despite major disparities in the level of myeloablation, intensity of immunosuppression, including large diversity of in vivo T-cell depletion, and post-graft immunomodulation, the different approaches have jointly contributed to a modification of the stage of allogeneic stem cell transplantation: transplant-related procedure mortality has been dramatically decreased, allowing for allogeneic immunotherapy to be used in previously excluded populations, including elderly patients, young but clinically unsuitable patients, patients with lymphoid malignancies or solid tumors, and patients without an HLA identical-related or unrelated donor. Together, these diverse regimens have provided one of the biggest breakthroughs since the birth of allogeneic bone marrow transplantation. These developments, which will most likely vary according to different clinical situations, have to continuously be compared to advances achieved in traditional allogeneic transplantation as well as non-transplantation treatments.