Department of Hematology, Ankara University School of Medicine, Ankara, Turkey.
Balkan Med J. 2017 Jan;34(1):1-9. doi: 10.4274/balkanmedj.2017.0055. Epub 2017 Jan 5.
Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is a curative treatment option for both malignant and some benign hematological diseases. During the last decade, many of the newer high-dose regimens in different intensity have been developed specifically for patients with hematologic malignancies and solid tumors. Today there are three main approaches used prior to allogeneic transplantation: Myeloablative (MA), Reduced Intensity Conditioning (RIC) and Non-MA (NMA) regimens. MA regimens cause irreversible cytopenia and there is a requirement for stem cell support. Patients who receive NMA regimen have minimal cytopenia and this type of regimen can be given without stem cell support. RIC regimens do not fit the criteria of MA and NMA: the cytopenia is reversible and the stem cell support is necessary. NMA/RIC for Allo-HSCT has opened a new era for treating elderly patients and those with comorbidities. The RIC conditioning was used for 40% of all Allo-HSCT and this trend continue to increase. In this paper, we will review these regimens in the setting of especially allogeneic HSCT and our aim is to describe the history, features and impact of these conditioning regimens on specific diseases.
异基因造血干细胞移植（Allo-HSCT）是治疗恶性和某些良性血液系统疾病的一种有治愈可能的治疗选择。在过去的十年中，已经专门为血液系统恶性肿瘤和实体瘤患者开发了许多不同强度的新型高强度方案。目前，在进行异基因移植之前有三种主要方法：清髓性（MA）、强度降低的预处理方案（RIC）和非清髓性（NMA）方案。MA 方案会导致不可逆转的血细胞减少，需要干细胞支持。接受 NMA 方案的患者血细胞减少程度较轻，这种方案可以在没有干细胞支持的情况下给予。RIC 方案不符合 MA 和 NMA 的标准：血细胞减少是可逆的，需要干细胞支持。用于异基因 HSCT 的 NMA/RIC 为治疗老年患者和合并症患者开辟了一个新时代。RIC 预处理方案用于所有 Allo-HSCT 的 40%，这一趋势还在继续增加。本文将在异基因 HSCT 的背景下对这些方案进行综述，我们的目的是描述这些预处理方案在特定疾病中的历史、特点和影响。
