CCONMDPSatellite2009Devine分子分型骨髓移植.ppt

AML, acute myeloid leukemia; ATG, antithymocyte globulin; BMT CTN, Blood and Marrow Transplant Clinical Trials Network; CR, complete remission; MDACC, University of Texas M. D. Anderson Cancer Center. ? This is an incomplete list of the ongoing cooperative group or consortia efforts to evaluate new methods to prevent GVHD. The Blood and Marrow Transplant Clinical Trials Network (BMT CTN) is currently performing a trial in recipients of matched sibling donor transplantations, comparing tacrolimus with either methotrexate or sirolimus for GVHD prophylaxis. In addition, we have just completed BMT CTN 0303, which is a T-cell depletion trial. In addition, a consortium from Johns?Hopkins University, the University of Texas M. D. Anderson Cancer Center, and the Fred Hutchinson Cancer Research Center is conducting prospective trials of the use of posttransplantation cyclophosphamide to deplete alloreactive T?cells in patients undergoing bone marrow transplantations from matched sibling and matched unrelated donors. I think this is a very interesting approach in these patients, many of whom do not develop acute or chronic GVHD and do not require long-term immunosuppression. Finally, approaches, including use of polyclonal and monoclonal antibodies are in early-stage investigation. * * ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; CR1, first complete remission. ? T-cell depletion is an old concept that is considered to be associated with a lot of problems. However, it is interesting that centers that have focused on T-cell depletion have had very good outcomes in patients with AML who underwent transplantation in first or second remission. Data from the University of Perugia, Memorial Sloan-Kettering Cancer Center, the Dana-Farber Cancer Institute, and other groups have demonstrated very favorable outcomes for patients transplanted earlier in the course of disease. ? * AML, acute myeloid leukemia; ATG, antithymocyte globulin; BMT CTN, Blood and Marrow Tra