Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies

被引:354
作者
Huang, X. -J. [1 ]
Liu, D. -H. [1 ]
Liu, K. -Y. [1 ]
Xu, L. -P. [1 ]
Chen, H. [1 ]
Han, W. [1 ]
Chen, Y. -H. [1 ]
Wang, J. -Z. [1 ]
Gao, Z. -Y. [1 ]
Zhang, Y. -C. [1 ]
Jiang, Q. [1 ]
Shi, H. -X. [1 ]
Lu, D. -P. [1 ]
机构
[1] Peking Univ, Inst Hematol, Peoples Hosp, Beijing 100044, Xicheng Distric, Peoples R China
基金
中国国家自然科学基金;
关键词
hematopoietic stem cell transplantation; allogeneic; HLA; mismatched; haploidentical;
D O I
10.1038/sj.bmt.1705445
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Many patients who require allogeneic hematopoietic stem cell transplantation (allo-HSCT) lack a human leukocyte antigen (HLA)-matched donor. Here, we report a protocol for haploidentical allo-HSCT that combines granulocyte-colony stimulating factor primed bone marrow (G-BM) and peripheral blood stem cells (PBSC) without in vitro T-cell depletion (TCD). In this study, 171 patients, including 86 in high-risk group, underwent transplantation from haploidentical family donors. All patients achieved sustained, full donor chimerism. One hundred and eleven patients were alive in remission at a median of 682 (253-1502) days. The cumulative incidence of grade III-IV acute graft-versus-host disease (GVHD) was 23% and that of extensive chronic GVHD, 47%; these were not influenced by HLA disparity. Patients younger than 15 years had less grade III-IV acute GVHD than older patients (P = 0.044). The 2-year probability of relapse was 12% for standard-risk disease and 39% for high-risk disease. The 2-year probability of leukemia-free survival (LFS) was 68% for standard-risk patients and 42% for high-risk patients (P = 0.0009). Grade III-IV acute GVHD was associated with better LFS (P = 0.0017). The results require confirmation and show that G-BM combined with PBSC from haploidentical family donors, without in vitro TCD, maybe used as a good source of stem cells for allo-HSCT.
引用
收藏
页码:291 / 297
页数:7
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