In vivoT-cell depletion using alemtuzumab in family and unrelated donor transplantation for pediatric non-malignant disease achieves engraftment with low incidence of graft vs. host disease
| Autor: | Helena Lee, Roisin E. Borrill, A. Logan, Andrew Turner, Stephen M. Hughes, Denise Bonney, Brian W. Bigger, Kay Poulton, Rob Wynn, M. A. Saif |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Transplantation Conditioning Adolescent T-Lymphocytes Graft vs Host Disease Viremia Antibodies Monoclonal Humanized Viral infection Gastroenterology Adenoviridae Young Adult Immune system Metabolic Diseases immune system diseases Unrelated Donor In vivo Internal medicine medicine Humans Transplantation Homologous Child Alemtuzumab Retrospective Studies Transplantation Chimera Transplantation business.industry Incidence Incidence (epidemiology) Hematopoietic Stem Cell Transplantation Anemia Aplastic Infant medicine.disease Treatment Outcome surgical procedures operative Child Preschool Pediatrics Perinatology and Child Health Immunology Female Unrelated Donors business Immunosuppressive Agents medicine.drug |
| Zdroj: | Pediatric Transplantation. 19:211-218 |
| ISSN: | 1397-3142 |
| DOI: | 10.1111/petr.12416 |
| Popis: | In vivo T-cell depletion, using alemtuzumab therapy prior to SCT, can reduce the incidence of GVHD. This treatment has a potential to delay immune reconstitution resulting in increased morbidity due to viral illnesses. We retrospectively analyzed data on all pediatric patients with non-malignant disorders who received alemtuzumab-based conditioning regimens in our center over the last 10 yr (n = 91). Our data show an OS of 91.2%. The incidence of acute (grade 2-4) GVHD was 18.7% and that of chronic GVHD 5.5%. Viremia due to adenovirus, EBV and CMV was seen in 19.8%, 64.8% and 39.6% patients, respectively, with only two deaths attributed to viral infection (adenovirus). Chimerism level at three month was predictive of graft outcome. Nine patients, who had graft failure after first SCT, were salvaged with a second SCT using RIC and same donor (if available). Based on these results, we conclude that the use of in vivo T-cell depletion is safe, achieves good chimerism and does not lead to increased morbidity and mortality due to viral infections. It is associated with a reduced incidence of chronic GVHD. |
| Databáze: | OpenAIRE |
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