Author Affiliation: Blood and Marrow Transplant Program, University of Michigan, Ann Arbor.
Allogeneic hematopoietic stem cell transplantation (HSCT) offers the opportunity for cure among patients with various hematologic malignancies.1 However, until the mid-1990s, allogeneic HSCT had only been offered to relatively young, otherwise healthy patients because it required high-dose chemotherapy and radiation therapy to myeloablate and immune-ablate patients to ensure engraftment.2 Since then, reduced-intensity allogeneic HSCT has been tried, using approximately half the dose of chemotherapy compared with conventional full-intensity allogeneic HSCT.3,4 Reduced-intensity allogeneic HSCT demonstrated that myeloablation was not as necessary as had been thought. This conceptual change created the opportunity to offer allogeneic HSCT to older patients.
Shin Mineishi. Overcoming the Age Barrier in Hematopoietic Stem Cell TransplantationProgress, but Still a Long Way to Go. JAMA. 2011;306(17):1918–1920. doi:10.1001/jama.2011.1612