Defining the Intensity of Conditioning Regimens: Working Definitions

Andrea Bacigalupo(Ospedale Policlinico San Martino), Karen K. Ballen(Massachusetts General Hospital), Doug Rizzo(Medical College of Wisconsin), Sergio Giralt(The University of Texas MD Anderson Cancer Center), Hillard M. Lazarus(University Hospitals of Cleveland), Vincent T. Ho(Dana-Farber Cancer Institute), Jane F. Apperley(Hammersmith Hospital), Shimon Slavin, Marcelo C. Pasquini(Medical College of Wisconsin), Brenda M. Sandmaier(Fred Hutch Cancer Center), John Barrett(National Institutes of Health), Didier Blaise(Institut Paoli-Calmettes), Robert Lowski(Stanford University), Mary M. Horowitz(Medical College of Wisconsin)
Biology of Blood and Marrow Transplantation
September 2, 2009
10.1016/j.bbmt.2009.07.004
Cited by 1,789Open Access
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Abstract

Defining conditioning regimen intensity has become a critical issue for the hemopoietic stem cell transplant (HSCT) community. In the present report we propose to define conditioning regimens in 3 categories: (1) myeloablative (MA) conditioning, (2) reduced-intensity conditioning (RIC), and (3) nonmyeloablative (NMA) conditioning. Assignment to these categories is based on the duration of cytopenia and on the requirement for stem cell (SC) support: MA regimens cause irreversible cytopenia and SC support is mandatory. NMA regimens cause minimal cytopenia, and can be given also without SC support. RIC regimens do not fit criteria for MA or NMA regimens: they cause cytopenia of variable duration, and should be given with stem cell support, although cytopenia may not be irreversible. This report also assigns commonly used regimens to one of these categories, based upon the agents, dose, or combinations. Standardized classification of conditioning regimen intensities will allow comparison across studies and interpretation of study results.

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