The impact of T-cell depletion techniques on the outcome after haploidentical hematopoietic SCT
Autor: | Bernhard Gerber, Jörg Halter, Jacob Passweg, Martin Stern, Alois Gratwohl, Thomas Kühne, Urs Schanz, R Seger, Georg Stussi, Marc Ansari, Tayfun Güngör, Yves Chalandon, André Tichelli, Hulya Ozsahin, A Marek |
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Přispěvatelé: | University of Zurich, Stussi, G |
Rok vydání: | 2013 |
Předmět: |
Male
Transplantation Conditioning CD3 Complex 2747 Transplantation Neutrophils T-Lymphocytes 2720 Hematology Graft vs Host Disease Antigens CD34 Gastroenterology Recurrence Child Alemtuzumab ddc:616 Incidence (epidemiology) Hematopoietic Stem Cell Transplantation Hematology Middle Aged Hematopoietic Stem Cell Mobilization Treatment Outcome surgical procedures operative Child Preschool Hematologic Neoplasms Monoclonal cardiovascular system Female Switzerland medicine.drug Adult medicine.medical_specialty Adolescent Antigens CD19 610 Medicine & health Antineoplastic Agents Antibodies Monoclonal Humanized Lymphocyte Depletion Young Adult Internal medicine medicine Humans Retrospective Studies Transplantation Neutrophil Engraftment business.industry Infant Newborn Infant Retrospective cohort study medicine.disease Graft-versus-host disease 10036 Medical Clinic 10032 Clinic for Oncology and Hematology Immunology Adsorption business |
Zdroj: | Bone Marrow Transplantation, Vol. 49, No 1 (2014) pp. 55-61 |
ISSN: | 1476-5365 0268-3369 |
Popis: | Several T-cell depletion (TCD) techniques are used for haploidentical hematopoietic SCT (HSCT), but direct comparisons are rare. We therefore studied the effect of in vitro TCD with graft engineering (CD34 selection or CD3/CD19 depletion, 74%) or in vivo TCD using alemtuzumab (26%) on outcome, immune reconstitution and infections after haploidentical HSCT. We performed a retrospective multicenter analysis of 72 haploidentical HSCT in Switzerland. Sixty-seven patients (93%) had neutrophil engraftment. The 1-year OS, TRM and relapse incidence were 48 (36-60)%, 20 (11-33)% and 42 (31-57)%, respectively, without differences among the TCD groups. In vivo TCD caused more profound lymphocyte suppression early after HSCT, whereas immune recovery beyond the second month was comparable between the two groups. Despite anti-infective prophylaxis, most patients experienced post-transplant infectious complications (94%). Patients with in vivo TCD had a higher incidence of CMV reactivations (54% vs 28%, P=0.015), but this did not result in a higher TRM. In conclusion, TCD by graft engineering or alemtuzumab are equally effective for haploidentical HSCT. |
Databáze: | OpenAIRE |
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