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Preparative regimens for hematopoietic cell transplantation

Author
Robert S Negrin, MD
Section Editor
Nelson J Chao, MD
Deputy Editor
Alan G Rosmarin, MD

INTRODUCTION

The preparative or conditioning regimen is a critical element in the hematopoietic cell transplant procedure. The purpose of the preparative regimen is twofold:

To provide adequate immunosuppression to prevent rejection of the transplanted graft

To eradicate the disease for which the transplant is being performed

These goals have traditionally been achieved by delivering maximally tolerated doses of multiple chemotherapeutic agents with non-overlapping toxicities, with or without radiation. Several novel approaches have been evaluated in an attempt to minimize toxicity. As an example, nonmyeloablative preparative regimens have been developed to treat older patients or those with concurrent medical conditions.

The toxicity associated with preparative regimens and an overview of the more common regimens currently in use will be presented here. The preferred preparative regimen for specific diseases and the approaches to prevention of the other major complications of hematopoietic cell transplantation (eg, graft-versus-host disease) are discussed separately. There are also occasional settings in which transplantation can be performed without any preparation, primarily in children with severe combined immunodeficiency who lack T cell function [1]. (See "Hematopoietic cell transplantation for primary immunodeficiency".)

                   

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Literature review current through: Nov 2016. | This topic last updated: Thu Jan 07 00:00:00 GMT+00:00 2016.
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