Nonmyeloablative allogeneic stem-cell transplantation for XXXX : a systematic review.

@entity1 @entity137 @entity2132 @entity1583 @entity5501
BACKGROUND: Increasingly, clinicians advocate the use of nonmyeloablative allogeneic stem-cell transplants (NM-allo-SCTs, "mini-transplants") to manage @entity1583 . They hypothesize that NM-allo-SCT is equally efficacious to standard allo-SCT but produces less regimen-related @entity137 . METHODS: To analyze available evidence on the benefits and harms of "mini-transplants," we identified 23 manuscripts, 1 abstract, and 1 letter that reported the outcome of mini-transplants in @entity1583 . RESULTS: Data were compiled on 603 treated @entity1 , with 118 transplants using stem cells from matched unrelated donors. All studies were small prospective case series, and most lacked concurrent or historical controls. Outcomes of interest were not uniformly reported. The studies were heterogeneous and used different @entity1 selection criteria, conditioning regimens, and timing of transplant with respect to disease status. The transplant-related mortality rate was 32%, the relapse rate was 15%, and @entity137 included acute and chronic @entity2132 and @entity5501 . The aggregate rate of complete remission was 45%. Survival at 1 year or longer ranged from 30% to 60% at 1 to 5 years of follow-up. All studies reported successful chimerism. CONCLUSIONS: Disease-specific studies with longer follow-up are needed to evaluate this potentially promising therapy.
