The efficacy of haplo-HSCT in high-risk patients with hematological malignancies. A single centre experience

Cellular Therapy and Transplantation

Boris V. Afanasyev¹  Natalia E. Ivanova¹  Olesya V. Paina¹  Elena V. Babenko¹  Alexander L. Alyanskiy¹  Alla A. Golovacheva¹  Natalia V. Stancheva¹  Elena V. Semenova¹  Ludmila S. Zubarovskaya¹ 

关键词: Haplo-HSCT;    T cell-replete SCT;    T cell-depleted SCT;    graft failure;    relapse;   

DOI  :  10.3205/ctt-2010-No9-abstract54

学科分类：肿瘤学

来源: Universitaetsklinikum Hamburg - Eppendorf / University Medical Center Hamburg - Eppendorf

【 摘 要 】

Introduction:Haplo-HSCTisatreatmentoptionfortheapproximately70%ofptswhodon’thaveanHLA-identicalsiblingdonor.Theprincipalcauseslimitingtheuseofhaplo-HSCTareinfectiouscomplication,severeGVHDfollowingTcell-repleteSCT,graftfailure,andrecurrentmalignancyafterTcell-depletedSCT.Aim:Toinvestigatetheefficiencyofhaplo-HSCTwithandwithouttheuseofpartialCD34+cellselectioninpatientswithhigh-riskhematologicalmalignancies.Methods:Fortyptswereincludedinthestudy.Thirty-threewerechildrenandadolescents(1–21yrs):11ptsin2orgt;remission(5ALLpts,5AMLpts,and1Ewing’ssarcomapt),and22ptsinrelapseoradvanceddisease(12ALLpts,7AMLpts,1AApt,1CMLac.Phasept,and1Neuroblastomapt).Sevenwereadultpts(21–46yrs):1ptin2orgt;remission-AML,and6ptsinrelapseoradvanceddisease(3ALLpts,2AMLpts,and1NHLpt).TheconditioningregimenusedwasMACfor14pts(AraC-Bu-Cy-CCNU-ATG)andRIC(17ptsFlu-Bu-ATG;3ptsFlu-Tio-Melph;4ptsother)fortheremaining26.ProphylaxisforaGVHDwasCsA-basefor28pts,and12ptsreceivedTacro-baseprophylaxis.ThecellsourcewasG-CSFstimulatedunmanipulatedBMin3pts;andG-CSFstimulatedBM+PBSCCD34+cellsin37pts.PBSCCD34+cellswereselectedusingtheCliniMACSdevice(MiltenyiBiotec).ThetotalquantityofPBSC+BMCD34+cellsinfusedintotherecipientwas11.5x106/kg.Results:EngraftmentandfulldonorchimerismwereachievedatD+60in28pts(70%),andprimarygraftfailurewasdiagnosedin12pts(30%),despitethehigh-riskaspectsofthisgroup.One-yearOSforalltreatedpatientswas45%.ForptswhoweretransplantedinCR2gt;1-yrOSwas50%andforrelapseoradvanceddiseaseitwas42.9%.ForALLpts1-yrOSwas55%(60%forCR2gt;and23.3%forrelapsedoradvanced-stagepts).One-yrOSforAMLptswas33.3%(50%forCR2gt;and22.2%forrelapsedoradvanced-stagepts).InptswhoachievedfulldonorchimerismonD+60,1-yOSwas53.6%,andforptswhodidnotachievedonorchimerismitwas25%(plt;0.01).Conclusions:Haplo-HCSTprolongsOSinpatientswithhigh-riskhematologicalmalignanciesandpossiblycarriesoutanimmunoadoptivetherapeuticalrole,which,possibly,isaseffectiveasAMLandALL.

【 授权许可】

Unknown