Salvage Haploidentical Transplantation Using Low-dose ATG for Early Disease Relapse after First Allogeneic Transplantation: A Retrospective Single-center Review
| Autor: | Sachiyo, Okamoto, Ken-Ichi, Matsuoka, Maiko, Sakamoto, Yoshiaki, Usui, Yuki, Fujiwara, Takumi, Kondo, Katsuma, Tani, Kyosuke, Saeki, Yusuke, Meguri, Noboru, Asada, Daisuke, Ennishi, Hisakazu, Nishimori, Keiko, Fujii, Nobuharu, Fujii, Yoshinobu, Maeda |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Salvage Therapy relapse anti-T lymphocyte globulin Hematopoietic Stem Cell Transplantation Graft vs Host Disease Middle Aged Progression-Free Survival Young Adult Treatment Outcome surgical procedures operative HLA Antigens Recurrence immune system diseases allogeneic stem cell transplantation Case-Control Studies hemic and lymphatic diseases Humans Female haploidentical stem cell transplantation therapeutics human activities Aged Retrospective Studies |
| Zdroj: | Acta Medica Okayama. 73(2):161-171 |
| ISSN: | 0386-300X |
| Popis: | Second allogeneic stem cell transplantation (allo-SCT) is a potentially curative therapy for patients who relapse after first allo-SCT. Human leukocyte antigen (HLA)-haploidentical related donors provide the broad opportunity to conduct second SCT at the appropriate time, but the efficacy of second SCT from haploidentical donors after relapse has not been established. We retrospectively analyzed the records of 33 patients who underwent second SCT. Twenty patients underwent haplo-SCT with low-dose antithymocyte globulin (ATG), and the other 13 patients underwent conventional- SCTs, including HLA-matched related peripheral blood, unrelated bone marrow or cord blood. Three years after the second SCT, the overall survival (OS) and progression-free survival (PFS) of all patients were 32.5% and 23.9%. Multivariate analyses indicated that non-complete response at second SCT, less than 1-year interval to relapse after first- SCT, and total score ≥ 3 on the hematopoietic cell transplantation-specific comorbidity index were significantly associated with a lower PFS rate. The haplo- and conventional- SCT groups showed equivalent results regarding OS, PFS, cumulative incidences of relapse, non-relapse mortality and graft-versus-host disease. The neutropenic period after transplantation was significantly shorter in haplo- SCT than conventional- SCT (10.5 days vs. 16 days, p=0.001). Our analysis revealed that haplo-SCT could be an alternative therapeutic option for relapsed patients after first SCT. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|