Summary:
The Third Workshop on reduced intensity conditioning allogeneic stem cell transplants (RIC-HSCT) was convened by EBMT/AMGEN in Zurich in February 2003. Three general issues were addressed: the age effect, graft-versus-host disease (GvHD) and donor lymphocyte infusions (DLI). An age effect is seen and has a negative impact on survival; GvHD remains an issue that needs to be addressed, and DLI were shown to be a powerful tool against minimal residual disease, but not with rapidly progressing leukemia. The role of host antigen-presenting cells in the development of acute GvHD was outlined and discussed in the animal model. The emerging importance of Epstein Barr Virus infections was also discussed. Retrospective and prospective studies from the EBMT, national groups and single institutions included over 1800 patients: the incidence of acute GvHD grade III–IV was 11% extensive chronic GvHD 22% and TRM 20%. Most conditioning regimens include fludarabine in association with a reduced dose of a myeloablative agent (busulfan, TBI, thiotepa or melphalan). Most transplants were from HLA-identical siblings (77%), and used peripheral blood (90%) as a stem cell source. A consensus discussion on current evidence in RIC transplants is reported in this paper.
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Acknowledgements
This Workshop was organized with an unrestricted educational grant by AMGEN Europe. I am grateful to my co-chairperson Shimon Slavin for his contribution, as well as to all discussants: David Nachbaur, Lars Vindelov, Tapani Ruutu, Didier Blaise, Jean-Michel Boiron, Mauricette Michallet, Dietger Niederwieser, Rainer Ordemann, Norbert Schmitz, Hubert Schrezenmeier, Alexander Knuth, Shimon Slavin, Benedetto Bruno, Paolo Corradini, Giorgio Dini, Maria Teresa Van Lint, Jan Cornelissen, Anton Shattenberg, Leo Verdonk, Manuel Abecasis, José A Peréz Simon, Jorge Sierra, Felipe Prosper, Lisbeth Barkholt, Bo Bjorkstrand, Alois Gratwohl, Taner Demirer, Charles Crawley, Karl Peggs, Martin Wright and David Calland.
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Bacigalupo, A. Third EBMT/AMGEN Workshop on reduced-intensity conditioning allogeneic haemopoietic stem cell transplants (RIC-HSCT), and panel consensus. Bone Marrow Transplant 33, 691–696 (2004). https://doi.org/10.1038/sj.bmt.1704416
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DOI: https://doi.org/10.1038/sj.bmt.1704416
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