The Patients' Stories

Successful Case Stories, Published in Scientific Journals

The first elderly patient who underwent successful allogeneic stem cell transplantation for advanced chronic lymphocytic leukemia on an outpatient basis

January 24, 2023
Shimon Slavin
The first elderly patient who underwent successful allogeneic stem cell transplantation for advanced chronic lymphocytic leukemia on an outpatient basis

Clinical application of NST or RIC instead of the conventional myeloablative transplant procedure made it possible to offer a cure for elderly patients with no upper age limit or to patients with poor performance status, using safer allogeneic stem cell transplantation procedure. Such patients would have been otherwise excluded from a conventional transplant procedure because of the risks involved in the conventional myeloablative transplant procedure. The patient, a lawyer from San Francisco shown here underwent a successful and uncomplicated transplant procedure from his fully matched brother following NST procedure in 2008 on an outpatient basis, never staying in the hospital even for one day.
Here too, the principle of NST was based on the idea that eliminating of chemo-radio resistant cancer cells can be mediated by alloreactive donor lymphocytes post-grafting and that the role of the transplant procedure was to induce tolerance and durable engraftment of the donor’s immune system cells following engraftment of donor’s hematopoietic stem cells.
This went against the existing dogma, of attempting to eliminate all malignant cells by maximum-tolerable doses of chemotherapy and/or radiation therapy, followed by a transplant procedure to rescue the patient from irreversibly lethal conditioning that destroyed all other essential cells in the bone marrow compartment. In other words, instead of trying to eliminate all cancer cells prior to the transplant procedure, cure could be accomplished following the transplant procedure thanks to the graft-versus-leukemia effects capable of eliminating all residual malignant cells.

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