REDUCED INTENSITY CONDITIONING REGIMEN WORKSHOP-DEFINING THE DOSE SPECTRUM

By S. Giralt, K. Ballen, D. Rizzo, A. Bacigalupo, M. Horowitz, M. Pasquini, B. Sandmaier. Biology of Blood and Marrow Transplantation, 2009

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During the 2006 Tandem BMT 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) prior to hematopoietic cell transplantation (HCT). The goal of the workshop was to determine acceptance within the transplant community of available RIC definitions. The participants were surveyed during the workshop to state if they strongly agreed, agreed, disagreed or strongly disagreed with specific statements on conditioning regimen intensity. The questions included the “Champlin criteria” as well as operational definitions used in registries studies exemplified in clinical vignettes. Fifty-six participants including transplant physicians, transplant center directors and transplant nurses with a median of 12 years of experience in HCT answered the survey. Sixty-seven percent agreed with statements that a RIC regimen should cause reversible myelosuppression when administered without stem cell support; result in low non-hematologic toxicity and after transplantation results in mixed donor-recipient chimerism at the time of first assessment in the majority of patients. Likewise the majority (71%) agreed or strongly agreed that regimens with less than 500 cGy of total body irradiation as a single fraction or 800 cGy in fractionated doses, busulfan less than 9 mg/kg, melphalan less than 140 mg/m2 or thiotepa less than 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) be considered a RIC regimen. These results demonstrate that although a consensus of what constitutes a RIC regimen does not exist among HCT professionals, currently used criteria and operational definitions are accepted by a majority of them. These results support the continued use of current criteria for RIC regimens until a consensus statement is developed.

Subfields: Hematology, Oncology, Pediatrics, Perinatology and Child Health

View Paper: https://www.semanticscholar.org/paper/ec1c88e61d4e4199bdd85f229370b719ae9c66fa

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Citations in the corpus

DEFINING THE INTENSITY OF CONDITIONING REGIMENS : working definitions (2009, methodology): “A workshop was convened at a CIBMTR/ASBMT meeting to assess whether expert transplanters would agree on what is considered a MA regimen (20).”
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Umbilical cord blood transplantation: the first 25 years and beyond. (2013, methodology): “In addition, the use of nonmyeloablative or reduced intensity conditioning (RIC), pioneered in related donor and MUD transplantation, allowed older patients and those with comorbidities to be transplanted safely.(44,45) Both of these approaches were combined, initially by the Minnesota group, by usi”
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