Nonmyeloablative stem cell transplantation

The importance of the host immune responses in eradicating ATL cells and controlling disease onset or recurrence is underscored by a graft-versus-leukemia effect postallogeneic transplantation,6061 recurrence of disease after T-cell-depleted allogeneic stem cell transplants,64,66 and reports of ATL occurring postsolid organ transplan-tation.72 Reconstituted cellular immunity, as manifested by induction of cytotoxic T lymphocytes against HTLV-1-infected cells, in ATL patients after nonmyeloablative allogeneic stem cell transplantation from HTLV-1 -negative HLA-identical siblings may contribute to graft-versus-leukemia effects.73 These data, together with the high treatment-related mortality associated with standard allogeneic transplantation, have provided the impetus for studies, using low-intensity conditioning regimens.

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