Recent Developments In Allogeneic Hematopoietic Cell Transplantation

Recent Developments In Allogeneic Hematopoietic Cell Transplantation
Presentation by:Steven M Devine M.D.
Director, Blood and Marrow Transplant Program


Annual Numbers of Blood and Marrow Transplantations, 1970-2006

HEMATOPOIETIC STEM CELL TRANSPLANTS AT OSU BY CALENDAR YEAR
Indications for Hematopoietic Stem Cell Transplantation in North America
Allogeneic HSC Transplantation

Definitions

* Allogeneic
o Refers to the use of bone marrow, mobilized blood, or cord blood from a genetically different donor (family member, unrelated volunteer, banked cord blood)
* Autologous
o Refers to the use of the patients own bone marrow or mobilized blood
Allogeneic Versus Autologous Stem Cell
Benefits of Allogeneic Transplantation
Drawbacks of Allogeneic Transplantation
Who are Allogeneic Stem Cell Transplant Candidates?
Complications of Allogeneic Transplantation
Causes of Death after Transplantations Done in 2001-2006
Age of HSCT recipients
Trends in Allogeneic Transplantation
Current Challenges

* Reducing Regimen Related Toxicity
* Reducing Risk of GVHD and Rejection
* Enhancing Immune Reconstitution
* Expanding Options for Patients Without Matched Sibling Donors
* Refining Criteria for Transplantation

BMT vs Conventional Tx for AML with poor risk cytogenetics

GVL in Leukemia
Considerations for allograft candidates
Stem cell sources
Summary of randomized trials comparing graft source
Cord Blood Transplantations
Reduced Intensity Stem Cell Transplantation
Allogeneic Transplantations using Reduced Intensity Conditioning by Donor Type Registered
High Intensity versus Low
GVL Effect after non-myeloablative transplantation
Transplantation Considerations in patients with AML
Balancing Regimen efficacy with toxicity
Balancing efficacy and toxicity
Reduced Intensity Allogeneic Transplantation
Considerations for allograft candidates
Acute GVHD Prophylaxis
What are the benefits of T-cell depletion?
What are the drawbacks of T-cell depletion?
Transplantation Considerations in patients with AML
Graft versus Tumor Effects
Current Challenges

* Enhancing Immune Reconstitution
* Reducing Risk of GVHD and Rejection
* Reducing Regimen Related Toxicity
* Expanding Options for Patients Without Matched Sibling Donors
* Refining Criteria for Transplantation

Alternative Donor Allograft Sources
Refining Criteria for Transplantation
Clinical Research Activity in BMT

Recent Developments In Allogeneic Hematopoietic Cell Transplantation.ppt