αβ T Cell-Depleted Haploidentical Hematopoietic Stem Cell Transplantation without Antithymocyte Globulin in Children with Chemorefractory Acute Myelogenous Leukemia
| Autor: | Michael Maschan, Svetlana Radygina, Pavel Trakhtman, Alexei Maschan, Viktoria Zaharova, Dmitriy Balashov, Yulia Olshanskaya, Dmitriy Pershin, Varvara Brilliantova, Agnesa Panferova, Rimma Khismatullina, Galina Novichkova, Alexei Kazachenok, Maria Ilushina, Larisa Shelikhova, Yakov Muzalevskii, Zhanna Shekhovtsova, Daria Shasheleva, Dina Baidildina, Irina Kalinina, Alexander Rumyantsev, Elena Zerkalenkova, Elena Kurnikova |
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| Rok vydání: | 2019 |
| Předmět: |
Oncology
medicine.medical_specialty Receptors Antigen T-Cell alpha-beta medicine.medical_treatment Graft vs Host Disease ThioTEPA Hematopoietic stem cell transplantation Treosulfan Lymphocyte Depletion 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Transplantation Homologous Child Salvage Therapy Transplantation business.industry Hematopoietic Stem Cell Transplantation Hematology medicine.disease Donor Lymphocytes Survival Analysis Fludarabine Leukemia Myeloid Acute Leukemia Treatment Outcome surgical procedures operative Hypomethylating agent Lymphocyte Transfusion 030220 oncology & carcinogenesis Transplantation Haploidentical Cytarabine business 030215 immunology medicine.drug |
| Zdroj: | Biology of Blood and Marrow Transplantation. 25:e179-e182 |
| ISSN: | 1083-8791 |
| Popis: | We evaluated the outcome of αβ T cell-depleted haploidentical hematopoietic stem cell transplantation (HSCT) in a cohort of children with chemorefractory acute myelogenous leukemia (AML). Twenty-two patients with either primary refractory (n = 10) or relapsed refractory (n = 12) AML in active disease status received a transplant from haploidentical donors. The preparative regimen included cytoreduction with fludarabine and cytarabine and subsequent myeloablative conditioning with treosulfan and thiotepa. Antithymocyte globulin was substituted with tocilizumab in all patients and also with abatacept in 10 patients. Grafts were peripheral blood stem cells engineered by αβ T cell and CD19 depletion. Post-transplantation prophylactic therapy included infusion of donor lymphocytes, composed of a CD45RA-depleted fraction with or without a hypomethylating agent. Complete remission was achieved in 21 patients (95%). The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 18%, and the cumulative incidence of chronic GVHD was 23%. At 2 years, transplantation-related mortality was 9%, relapse rate was 42%, event-free survival was 49%, and overall survival was 53%. Our data suggest that αβ T cell-depleted haploidentical HSCT provides a reasonable chance of long-term survival in a cohort of children with chemorefractory AML and creates a solid basis for further improvement. |
| Databáze: | OpenAIRE |
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