Transplantation Biology entitled: ‘Megadose and Minitransplantation: what is the biology?’ was held on June 18, 2000. The session was chaired by Dr R Handgretinger. Dr M Schumm presented data on the transplantation of 39 pediatric patients with megadoses of mobilized purified CD34+ stem cells derived from haploidentical donors. Engraftment could be achieved by using a combination of high stem-cell numbers (median number of transplanted CD34+ stem cells: 20 106/kg) and a short post-transplant rejection prophylaxis with an anti-CD3 antibody. Immunoreconstitution was faster in patients receiving higher stem cell numbers. All except one patient finally engrafted. The concept that megadoses of CD34+ stem cells are necessary for engraftment in partially-mismatched related donors was challenged by Dr J Henslee-Downey. In her experience of both adult and pediatric patients, engraftment was achieved with T-cell depleted BM containing much lower doses of CD34+ stem cells. Grade III–IV GvHD was seen in 23% and 19% of the patients grafted with BM from donors with < 2 Ag and 3 Ag mismatch, respectively. Overall probability of chronic GvHD was 53%. The number of transplanted CD34+ stem cells had no influence on the outcome, and survival was only affected by advanced disease at time of transplantation. Dr Bornhauser presented data using a reduced nonmyeloablative regimen, followed by the transplantation of mobilized peripheral unseparated or positively selected CD34+ stem cells from matched unrelated donor. Mycofenolate mofetil and cyclosporin were used for GvHD prophylaxis. Although the intital tolerability was good and chemotherapy-related side effects were low, infections, GvHD or both still present a problem after cessation of immunosuppression. A close follow-up of the chimerism in lymphocyte subpopulations showed the dynamic of engraftment and the role of donor lymphocyte infusions in this transplant setting. The advantages and disadvantages of these different transplantion approaches were discussed by the attendees. There was an agreement that non-myeloablative therapies are more in favor for older patients, or for patients who are at high risk of toxicity with a myeloablative therapy. Most discussants agreed that myeloablative therapies still have their place in patients with malignancies, in order to maximize the antileukemic effect of the transplantion. Cytotherapy (2000) Vol. 2, No. 5, 391

中文翻译：

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大剂量和微型移植：生物学原理是什么？

移植生物学题为：“大剂量和微型移植：生物学是什么？” 于 2000 年 6 月 18 日举行。会议由 R Handgretinger 博士主持。M Schumm 博士提供了 39 名儿科患者的移植数据，这些患者移植了大量来自半相合供体的动员的纯化 CD34+ 干细胞。可以通过结合使用高干细胞数量（移植 CD34+ 干细胞的中位数：20 106/kg）和使用抗 CD3 抗体进行短期移植后排斥反应来实现移植。接受较高干细胞数量的患者的免疫重建速度更快。除了一名患者外，其他所有人最终都嫁接了。J Henslee-Downey 博士挑战了大剂量 CD34+ 干细胞移植到部分不匹配的相关供体中所必需的概念。根据她对成人和儿科患者的经验，植入是用 T 细胞耗尽的 BM 实现的，其中含有低得多的 CD34+ 干细胞剂量。分别在 23% 和 19% 的移植骨髓的患者中观察到 III-IV 级 GvHD，这些患者分别来自 <2 Ag 和 3 Ag 错配的供体。慢性 GvHD 的总体概率为 53%。移植的 CD34+ 干细胞数量对结果没有影响，存活率仅受移植时晚期疾病的影响。Bornhauser 博士使用减少的非清髓方案提供了数据，然后移植了来自匹配的无关供体的动员的外周未分离或阳性选择的 CD34+ 干细胞。霉酚酸酯和环孢菌素用于 GvHD 预防。虽然初始耐受性好，化疗相关副作用低，在免疫抑制停止后，感染、GvHD 或两者仍然存在问题。对淋巴细胞亚群中嵌合现象的密切跟踪显示了移植的动态和供体淋巴细胞输注在这种移植环境中的作用。与会者讨论了这些不同移植方法的优缺点。一致认为非清髓疗法更适合老年患者，或清髓疗法毒性高风险的患者。大多数讨论者同意清髓疗法在恶性肿瘤患者中仍然占有一席之地，以最大限度地发挥移植的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391 对淋巴细胞亚群中嵌合现象的密切跟踪显示了移植的动态和供体淋巴细胞输注在这种移植环境中的作用。与会者讨论了这些不同移植方法的优缺点。一致认为非清髓疗法更适合老年患者，或清髓疗法毒性高风险的患者。大多数讨论者同意清髓疗法在恶性肿瘤患者中仍然占有一席之地，以最大限度地发挥移植的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391 对淋巴细胞亚群中嵌合现象的密切跟踪显示了移植的动态和供体淋巴细胞输注在这种移植环境中的作用。与会者讨论了这些不同移植方法的优缺点。一致认为非清髓疗法更适合老年患者，或清髓疗法毒性高风险的患者。大多数讨论者同意清髓疗法在恶性肿瘤患者中仍然占有一席之地，以最大限度地发挥移植的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391 与会者讨论了这些不同移植方法的优缺点。一致认为非清髓疗法更适合老年患者，或清髓疗法毒性高风险的患者。大多数讨论者同意清髓疗法在恶性肿瘤患者中仍然占有一席之地，以最大限度地发挥移植的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391 与会者讨论了这些不同移植方法的优缺点。一致认为非清髓疗法更适合老年患者，或清髓疗法毒性高风险的患者。大多数讨论者同意清髓疗法在恶性肿瘤患者中仍然占有一席之地，以最大限度地发挥移植的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391 以最大限度地发挥移植物的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391 以最大限度地发挥移植物的抗白血病作用。细胞疗法 (2000) 卷。2、5号、391