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Sydney 2005:
High Dose or Reduced Intensity Conditioning for MM?
By William Bensinger, MD
04.13.05
Dr. Bensinger spoke about shifting burden from tumor to T cells to ablate disease. There is a wide range of treatment spectrums available to patients that are related to aggressiveness of the tumor and genetic disparity. Dr. Bensinger and associates adopted a tandem autologus/non-ablative allogeneic stem cell transplant strategy in response to poor outcomes observed with other strategies. Analysis of data at a 3 year follow up showed 60% survival and 40% PFS; only 17% of patients had died of treatment related mortalities (TRM). Lesson learned from CML include the use of high dose busulfan to improve survival and reduce relapse after allograft. Tandem autologous/allogeneic transplants showed a low rate of mortality (20%) and a high response rate (57% CR, 29% PR). Future goals include improving graft versus leukemia (GVL) and GVHD, upregulating target antigens with specific cytokines, and use of postxtransplant maintenance with agents such a thalidomide.


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