Rapid hematopoietic engraftment following fractionated @entity131 conditioning and transplantation with XXXX (+) enriched hematopoietic progenitor cells from partially mismatched related donors.

@entity1 @entity131 @entity1641 @entity784 @entity95 @entity3118 @entity281 @entity1583 @entity401 @entity2280
Nineteen adult @entity1 with poor-risk @entity1583 received @entity784 ( @entity784 ) hematopoietic progenitor cell (HPC) transplant from partially mismatched related donors (PMRD). The preparative regimen (FITFA) included fractionated @entity131 , thiotepa, @entity3118 , and @entity1641 (n = 3) or @entity95 (n = 16) anti-thymocyte anti-sera (ATG). GVHD prophylaxis consisted of @entity784 by positive/negative selection using the Isolex 300i system and pre-transplant ATG with no post-transplant immunosuppression. The mean number (+/-s.d.) of transplanted @entity2280 (+) and CD3(+) cells were 8.9 x 10(6)/kg +/-4.3 (range 2.6-19.3) and 1.4 x 10(4)/kg +/-1.2 (range 0.3-4.6) respectively. Seventeen @entity1 evaluable for neutrophil engraftment achieved an ANC >0.5 x 10(9)/l at a median of 12 days (range 9-27), with evidence of full donor chimerism. Thirteen @entity1 died of the following causes: relapse (n = 6), @entity281 (n = 5), @entity401 (n = 1), and unknown causes (n = 1) None of the recipients of @entity95 ATG required therapy for acute or chronic GVHD. Five @entity1 are alive and disease-free at a median time of 303 days post transplant (range 100-660). The FITFA preparative regimen using fractionated @entity131 is well tolerated and is sufficiently immunosuppressive to allow rapid and stable donor origin hematopoietic engraftment without 'mega' doses of @entity2280 (+) cells. Combination of stringent ex vivo @entity784 and pre-transplant ATG is effective GVHD prophylaxis.
