| Autor: |
Kazuhiro, Ikegame, Katsuji, Kaida, Keiko, Fukunaga, Yuko, Osugi, Kyoko, Yoshihara, Satoshi, Yoshihara, Shinichi, Ishii, Satoshi, Fujino, Takaya, Yamashita, Azusa, Mayumi, Satoshi, Maruyama, Masahiro, Teramoto, Takayuki, Inoue, Masaya, Okada, Hiroya, Tamaki, Hiroyasu, Ogawa, Yosihiro, Fujimori |
| Rok vydání: |
2019 |
| Předmět: |
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| Zdroj: |
Bone marrow transplantation. 56(1) |
| ISSN: |
1476-5365 |
| Popis: |
HLA haploidentical hematopoietic stem cell transplantation (HSCT), i.e., HSCT from a 1-HLA-haplotype-mismatched family donor, has been successfully performed even as a second transplantation for posttransplant relapse. Is the haploidentical the limit of HLA mismatches in HSCT? In order to explore the possibility of HLA-mismatched HSCT from family donors beyond haploidentical relatives, we conducted a prospective phase I/II study of 2-HLA-haplotype-mismatched HSCT (2-haplo-mismatch HSCT). We enrolled 30 patients with posttransplant relapse (acute myeloid leukemia: 18, acute lymphoblastic leukemia: 11, non-Hodgkin lymphoma: 1). 2-haplo-mismatch HSCT was performed as the second to sixth transplantations. The donors were siblings (n = 12), cousins (n = 16), and second cousins (n = 2). The conditioning regimen consisted of fludarabine, cytarabine, melphalan, low-dose anti-thymocyte globulin, and 3 Gy of total body irradiation. Graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus, methylprednisolone, and mycophenolate mofetil. All patients achieved neutrophil engraftment, except for a case of early death. The cumulative incidences of grades II-IV and III-IV acute GVHD were 36.7% and 16.7%, respectively. The overall survival at 1 year, relapse, and non-relapse mortality rates was 30.1%, 38.9%, and 44.3%, respectively. Considering the poor prognosis of posttransplant relapse, 2-haplo-mismatch HSCT can be an alternative option in a second or third transplantation. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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