Giralt Sergio, Ballen Karen, Rizzo Douglas, Bacigalupo Andreas, Horowitz Mary, Pasquini Marcelo, Sandmaier Brenda
University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA.
Biol Blood Marrow Transplant. 2009 Mar;15(3):367-9. doi: 10.1016/j.bbmt.2008.12.497.
During the 2006 BMT Tandem Meetings, a workshop was convened by the Center for International Blood and Marrow Transplant Research (CIBMTR) to discuss conditioning regimen intensity and define boundaries of reduced-intensity conditioning (RIC) before hematopoietic cell transplantation (HCT). The goal of the workshop was to determine the acceptance of available RIC definitions in the transplant community. Participants were surveyed regarding their opinions on specific statements on conditioning regimen intensity. Questions covered the "Champlin criteria," as well as operational definitions used in registry studies, exemplified in clinical vignettes. A total of 56 participants, including transplantation physicians, transplant center directors, and transplantation nurses, with a median of 12 years of experience in HCT, answered the survey. Of these, 67% agreed that a RIC regimen should cause reversible myelosuppression when administered without stem cell support, result in low nonhematologic toxicity, and, after transplantation, result in mixed donor-recipient chimerism at the time of first assessment in most patients. Likewise, the majority (71%) agreed or strongly agreed that regimens including < 500 cGy of total body irradiation as a single fraction or 800 cGy in fractionated doses, busulfan dose < 9 mg/kg, melphalan dose <140 mg/m(2), or thiotepa dose < 10 mg/kg should be considered RIC regimens. However, only 32% agreed or strongly agreed that the combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) should be considered a RIC regimen. These results demonstrate that although HCT professionals have not reached a consensus on what constitutes a RIC regimen, most accept currently used criteria and operational definitions. These results support the continued use of current criteria for RIC regimens until a consensus statement can be developed.
在2006年骨髓移植串联会议期间，国际血液和骨髓移植研究中心（CIBMTR）召开了一次研讨会，讨论预处理方案强度，并界定造血细胞移植（HCT）前减低强度预处理（RIC）的界限。该研讨会的目标是确定移植界对现有RIC定义的接受程度。就他们对预处理方案强度具体陈述的意见对参与者进行了调查。问题涵盖“钱普林标准”以及登记研究中使用的操作定义，并在临床案例中举例说明。共有56名参与者回答了该调查，其中包括移植医生、移植中心主任和移植护士，他们在HCT方面的中位经验为12年。其中，67%的人同意，RIC方案在无干细胞支持的情况下应用时应导致可逆性骨髓抑制，产生低非血液学毒性，并且在移植后，大多数患者首次评估时应产生供受者混合嵌合体。同样，大多数人（71%）同意或强烈同意，单次全身照射总剂量<500 cGy或分次照射剂量为800 cGy、白消安剂量<9 mg/kg、美法仑剂量<140 mg/m²或塞替派剂量<10 mg/kg的方案应被视为RIC方案。然而，只有32%的人同意或强烈同意卡莫司汀、依托泊苷、阿糖胞苷和美法仑（BEAM）的联合应用应被视为RIC方案。这些结果表明，尽管HCT专业人员在什么构成RIC方案上尚未达成共识，但大多数人接受目前使用的标准和操作定义。这些结果支持在制定共识声明之前继续使用目前的RIC方案标准。
