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
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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