Non-myeloablative allogeneic stem cell transplantation (also known
as mini-transplantation or reduced-intensity conditioning
transplantation) is a major advance in the field of hematopoietic
transplantation within the last 5 years. This approach uses
non-cytotoxic or reduced-intensity cytotoxic therapy to prepare
patients for allografting of hematopoietic stem cells and
lymphocytes. It has the potential to deliver the potent anti-tumor
immunotherapy and bone marrow replacement capacity of allogeneic
stem cell transplantation to patients with reduced
treatment-related morbidity and mortality. It may also enable
allogeneic transplantation in patients who would be considered
ineligible for conventional transplants because of co-morbidity or
advanced age. However, this approach may necessitate more careful
monitoring of post-transplant chimerism and malignant
disease-status than is usual with conventional allografting. There
is also controversy regarding the best preparative regimen and
graft-versus-host disease prophylaxis to use.
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