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🌱 來自：allogeneic_stem_cell_transplantation

conditioning_regimens-of-allogeneic_stem_cell_transplantation

• Myeloablative conditioning (MAC):
• Expected to destroy hematopoietic cells in the BM → results in pancytopenia that is long-lasting, usu irreversible, & in most instances fatal unless hematopoiesis restored by infusion of HSCs
• 預計會破壞骨髓中的造血細胞，並在給藥後一到三週內導致嚴重的全血球減少症
• 抑制宿主的免疫系統對於防止移植物排斥也很重要。
• 由此產生的全血球減少症是持久的，通常是不可逆的，
• 並且在大多數情況下是致命的，除非透過輸注造血幹細胞來恢復造血功能。
• eg, TBI ≥5 Gy single dose or ≥8 Gy fractionated; Bu ≥8 mg/kg PO or IV equivalent
  • BEAM
  • TBI_Cy (4.5 Gy × 2)
  • Bu4_Cy
  • Flu_Bu4
  • High dose melphalan
  • Flu_Mel_TBI is a reasonable alternative to CY/TBI
    • Comparison of Myeloablative Conditioning with Cyclophosphamide and Total-Body Irradiation (Cy/TBI) Vs. Fludarabine, Melphalan, and Total-Body Irradiation (Flu/Mel/TBI) in Patients Undergoing Allogeneic Stem Cell Transplant for AML/ALL | Blood | American Society of Hematology

Nonmyeloablative (NMA)

Cause minimal cytopenia but significant lymphopenia; following administration of allo-HSCs → engrafting donor T cells will eventually eliminate host hematopoietic cells allowing establishment of donor hematopoiesis (JCO 2005;23:1993)

• Eg, Flu + Cy w/ or w/o ATG, TBI ≤2 Gy w/ or w/o purine analog

Reduced intensity conditioning (RIC)

Intermediate in intensity, result in cytopenias that may be prolonged & result in significant morbidity/mortality, eg, Bu ≤9 mg/kg PO, melphalan ≤140 mg/m2