Graft vs GIST

摘要

Physicians specializing in hematopoietic SCT (HSCT) occasionally encounter the difficult situation of deciding whether to proceed with an allogeneic HSCT for a high-risk hematologic malignancy in a patient who has a different concomitant incurable but treatable low-grade neoplasm. In such patients, the risk of the low-grade neoplasm demonstrating altered natural history and progressing more quickly to become life threatening in the setting of immunosuppression is theoretically increased, but the magnitude of this risk is unknown. With the increasing availability of targeted therapies with relatively favorable safety profiles prolonging survival in these patients, the unique possibility of entering into an allogeneic HSCT for a high-risk hematologic malignancy while planning post-transplant targeted therapy for the low-grade neoplasm emerges. However, the likelihood that a patient will be a suitable candidate for such effective, otherwise relatively non-toxic targeted therapy after what can be a very complicated course post transplant is impossible to determine a priori.