Bone marrow toxicityMarrow damage and hematopoietic recovery following allogeneic bone marrow transplantation for acute leukemias: Effect of radiation dose and conditioning regimen
Section snippets
Patients
Medical records from 98 patients (47 male, 51 female) receiving allogeneic HCT using either TBI-containing MA or RIC regimens at the University of Minnesota between January 2003 and June 2013 were reviewed. Patients were limited to age 45–55 at HCT to avoid confounding age-related differences in marrow cellularity [22], [23].
Preparative regimens
MA conditioning included cyclophosphamide 60 mg/kg on day-6 and -5 pre-HCT followed by 1320 cGy TBI delivered in 8 twice-daily fractions. Those receiving umbilical cord blood
Results
Table 1 describes the demographic and clinical characteristics of the patients in each cohort. The MA and RIC cohorts were similar with respect to diagnosis, disease risk, prior autologous transplants, performance status and CMV serostatus. There was a slight male predominance in the MA cohort (60% versus 40% in the RIC cohort; p = 0.05). The majority (81%) of patients undergoing MA conditioning received hematopoietic stem cell grafts from matched sibling donors while most of the others (17%)
Discussion
In this study, we analyzed the longitudinal impact of MA and RIC regimens on the BM environment and functional reconstitution post-HCT. Due to the fact that there was considerable variation in the conditioning regimen and graft source for the RIC and MA patients, we did not seek to directly compare the individual marrow cellularity measurements and peripheral blood counts at specified time points. Rather, we examined the changes over time compared with the pre-transplant baseline for each
Conflict of interest
The authors declare no conflict of interest.
Acknowledgement
This work was supported by the National Institute of Health grants (1R01CA154491).
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