Maqbool S, Baloch MF, Khan MAK, Khalid A, Naimat K. Autologous hematopoietic stem cell transplantation conditioning regimens and chimeric antigen receptor T cell therapy in various diseases. World J Transplant 2024; 14(1): 87532 [PMID: 38576761 DOI: 10.5500/wjt.v14.i1.87532]
Corresponding Author of This Article
Shahzaib Maqbool, BSc, Doctor, MBBS, Academic Editor, Academic Research, Science Editor, Department of Medicine, Holy Family Hospital, Doctors Hostel, Room 36, Rawalpindi 46000, Pakistan. hasanshahzaib299@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Mar 18, 2024; 14(1): 87532 Published online Mar 18, 2024. doi: 10.5500/wjt.v14.i1.87532
Autologous hematopoietic stem cell transplantation conditioning regimens and chimeric antigen receptor T cell therapy in various diseases
Shahzaib Maqbool, Maryam Farhan Baloch, Muhammad Abdul Khaliq Khan, Azeem Khalid, Kiran Naimat
Shahzaib Maqbool, Department of Medicine, Holy Family Hospital, Rawalpindi 46000, Pakistan
Maryam Farhan Baloch, Department of Community Medicine, Allama Iqbal Medical College, Lahore 45000, Pakistan
Muhammad Abdul Khaliq Khan, Department of Community Dentistry, Baqai Medical University, Karachi 43000, Pakistan
Azeem Khalid, Department of Medicine, Allama lqbal Medical College, Lahore 45000, Pakistan
Kiran Naimat, Department of MedicineLiaquat University of Medical and Health Sciences, Karachi 43000, Pakistan
Author contributions: Maqbool S, Baloch MF, Khan MAK, and Khalid A contributed significantly and equally to the preparation of the manuscript, including primary and final drafting; Maqbool S, Khalid A, and Naimat K conceived, designed, and performed the study; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shahzaib Maqbool, BSc, Doctor, MBBS, Academic Editor, Academic Research, Science Editor, Department of Medicine, Holy Family Hospital, Doctors Hostel, Room 36, Rawalpindi 46000, Pakistan. hasanshahzaib299@gmail.com
Received: August 14, 2023 Peer-review started: August 14, 2023 First decision: September 14, 2023 Revised: October 21, 2023 Accepted: January 8, 2024 Article in press: January 8, 2024 Published online: March 18, 2024 Processing time: 213 Days and 9.3 Hours
Abstract
Conditioning regimens employed in autologous stem cell transplantation have been proven useful in various hematological disorders and underlying malignancies; however, despite being efficacious in various instances, negative consequences have also been recorded. Multiple conditioning regimens were extracted from various literature searches from databases like PubMed, Google scholar, EMBASE, and Cochrane. Conditioning regimens for each disease were compared by using various end points such as overall survival (OS), progression free survival (PFS), and leukemia free survival (LFS). Variables were presented on graphs and analyzed to conclude a more efficacious conditioning regimen. In multiple myeloma, the most effective regimen was high dose melphalan (MEL) given at a dose of 200/mg/m2. The comparative results of acute myeloid leukemia were presented and the regimens that proved to be at an admirable position were busulfan (BU) + MEL regarding OS and BU + VP16 regarding LFS. In case of acute lymphoblastic leukemia (ALL), BU, fludarabine, and etoposide (BuFluVP) conferred good disease control not only with a paramount improvement in survival rate but also low risk of recurrence. However, for ALL, chimeric antigen receptor (CAR) T cell therapy was preferred in the context of better OS and LFS. With respect to Hodgkin’s lymphoma, mitoxantrone (MITO)/MEL overtook carmustine, VP16, cytarabine, and MEL in view of PFS and vice versa regarding OS. Non-Hodgkin’s lymphoma patients were administered MITO (60 mg/m2) and MEL (180 mg/m2) which showed promising results. Lastly, amyloidosis was considered, and the regimen that proved to be competent was MEL 200 (200 mg/m2). This review article demonstrates a comparison between various conditioning regimens employed in different diseases.
Core Tip: This literature review study is based on real-world data collected from various published research introducing multiple conditioning regimens for different disorders. Comparisons between regimens of an individual disorder were made using variables such as overall survival, progression free survival, complete remission, and leukemia free survival to conclude a laudable conditioning regimen having trivial adverse effects. The article is designed to discuss the conditioning regimens employed in autologous stem cell transplantation for various diseases. The primary objective of conducting this review is to highlight the various conditioning regimens, and discuss both the positive and the negative consequences along with proposing a treatment that is both efficacious and harmless.
