Univ Prof Dietger Niederwieser Jos Carreras Transplantationseinheit Hmatologie

Univ. Prof. Dietger Niederwieser José Carreras Transplantationseinheit Hämatologie und intern. Onkologie Leipzig

East German study group (OSHO): Proportion of patients alive OS of AML patients according to age 1 0. 8 0. 62± 0. 16 0. 4 £ 60 years >60 years p=0. 0005 0. 2 0. 17± 0. 41 0 0 1 2 Time from diagnosis (years) 3

HSCT - rates in Europe 2000 Total transplants (1 st. ) per 10 million 0 or no report 1 - 50 51 - 200 201 - 400 > 400

EBMT SURVEY ON BMT IN 2000 Donor type and source BM PBPC Total 2989 3415 6404 1700 2255 3955 HLA-nid 84 353 437 twin 14 44 58 unrel 1191 763 1954 566 12166 12732 Allogeneic total HLA-id Autologous Preliminary data 9. 2001

EBMT SURVEY ON BMT IN 2000 Main Indications Allo Auto Total Leukemias 4653 1764 6417 Lymphomas 820 8498 9318 SAA 287 1 288 Solid tumors 104 2286 2390 Non malignant disorders 413 99 512 Others 127 84 211 Total 6404 12732 19136 Preliminary data 9. 2001

Changes in stem cell source 1990 -1997 100 % 90 80 70 BM allo 60 PBPC allo 50 40 BM auto 30 PBPC auto 20 10 0 1991 1992 1993 1994 1995 1996 1997 7 / 98

Stem Cell Transplantation In DLA-identical Littermate Dogs With Minimal Conditioning (R. Storb, Blood, 89: 3048 -3054)

Induction of chimerism for the treatment of hematological malignancies using unrelated donors University Leipzig, Germany FHCRC, Seattle, USA Stanford University, USA

Treatment Protocol: HLA-Matched Related Grafts 2 Gy. TBI HSCT Chimerism Analyses FLU -4 -3 -2 -1 0 28 CSP 6. 25 mg/kg po bid 35 56 84 MMF 15 mg/kg po bid Fludarabine: 30 mg/m 2/day (110 / 212 pts) PBSC HSCT: CD 34+: 8. 0 x 106/kg (1. 0 -42. 6) CD 3+: 3. 6 x 108/kg (0. 3 -68. 0) 180

Hematologic Changes Following Autologous and Allogeneic Transplantation Allo Auto Neutrophils Platelets ASH Plenary 2001

RESULTS • Full Chimerism can be induced with minimal conditioning also using unrelated donors. 6 out of 52 patients rejected. • 25 / 52 patients (48%) are alive after a median observation time of 210 days (range 13 -655). • The TRM is low with 25% despite high age and contraindication for conventional SCT. • Graft-versus-Host-Disease grade II-IV occurred in 33 / 46 evaluable patients (71, 7%) and was lethal in 6 patients (13%).

HSCT after 200 c. Gy±Fludarabine in patients mit de novo or secundary AML ( n = 22 ) Wahrscheinlichkeit 1, 0 0, 8 LFS 0, 64 0, 11 0, 6 Rezidiv 0, 4 0, 2 0, 32 0, 11 TRM 0 0 12 24 Monate 0, 06 0, 05 36

Marc Frederick freut sich: Fett ist die ideale Quelle für Stammzellen, denn es gibt eine Menge davon. „Wer es also zukünftig nicht schafft, die überflüssigen Pfunde auf herkömmliche Weise loszuwerden, kann es ja mit einer Stammzellspende versuchen.

Fred Hutchinson Cancer Research Center Seattle VA Hospital Rainer Storb Marie-Térèse Little Brenda Sandmaier David Maloney Mike Maris Jerry Radich Art Molina Tom Chauncey Chris Flowers Lyle Feinstein Ann Woolfrey Mary Flowers Bill Bensinger Ted Gooley Beverly Torok-Storb Stanford University Judy Shizuru Karl Blume University of Colorado Peter Mc. Sweeney University of Leipzig City of Hope U. Hegenbart W. Pönisch; Uharek F. Kamprath; Th. Lange Firoozeh Sahebi Ashwin Kashyap Stephen Forman AND THE TRANSPLANT TEAMS