The FLAMSA concept-past and future.
Ann. Hematol. 99, 1979–1988 (2020)
The FLAMSA reduced intensity (RIC) concept, also known as "sequential therapy", is a conceptual platform for the treatment of leukemia separated in several parts: induction therapy, a sequence of antileukemic and immunosuppressive conditioning for allogeneic stem cell transplantation, and immune restitution supported by donor lymphocyte transfusions. The antileukemic part consists of fludarabine, cytosine arabinoside, and amsacrine (FLAMSA); non-cross reactive agents like fludarabine and amsacrine have been successfully used in cases of refractoriness and relapse. Immunosuppressive conditioning and transplantation follow after only 3 days of rest. This way, the toxicity of allogeneic transplantation could be reduced and the anti-leukemia effects by using allogeneic immune cells could be optimized. This review summarizes available data on efficacy and toxicity of this approach. Further, possible strategies for improvements are discussed in order to provide better chances for elderly and frail patients and patients with advanced and high-risk disease. Among others, several new agents are available that target molecular changes of leukemia for induction of remission and allow for bridging the time after transplantation until adoptive immunotherapy becomes safe and effective.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Review
Typ der Hochschulschrift
Herausgeber
Schlagwörter
Aml ; Mds ; Transplantation ; Conditioning ; Flamsa ; Dli ; Graft Versus Leukemia ; Targeted Therapy; Acute Myeloid-leukemia; Stem-cell Transplantation; Versus-host-disease; Bone-marrow-transplantation; Chronic Myelogenous Leukemia; Donor Lymphocyte Infusions; Minimal Residual Disease; Acute Nonlymphocytic Leukemia; Low-dose Cytarabine; Adoptive Immunotherapy
Keywords plus
Sprache
englisch
Veröffentlichungsjahr
2020
Prepublished im Jahr
HGF-Berichtsjahr
2020
ISSN (print) / ISBN
0939-5555
e-ISSN
1432-0584
ISBN
Bandtitel
Konferenztitel
Konferzenzdatum
Konferenzort
Konferenzband
Quellenangaben
Band: 99,
Heft: ,
Seiten: 1979–1988
Artikelnummer: ,
Supplement: ,
Reihe
Verlag
Springer
Verlagsort
One New York Plaza, Suite 4600, New York, Ny, United States
Tag d. mündl. Prüfung
0000-00-00
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Gutachter
Prüfer
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Veröffentlichungsdatum
0000-00-00
Anmeldedatum
0000-00-00
Anmelder/Inhaber
weitere Inhaber
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Priorität
Begutachtungsstatus
Peer reviewed
POF Topic(s)
30504 - Mechanisms of Genetic and Environmental Influences on Health and Disease
Forschungsfeld(er)
Immune Response and Infection
PSP-Element(e)
G-520360-001
Förderungen
Copyright
Erfassungsdatum
2020-07-08