دورية أكاديمية
Treatment of graft failure with TNI-based reconditioning and haploidentical stem cells in paediatric patients.
العنوان: | Treatment of graft failure with TNI-based reconditioning and haploidentical stem cells in paediatric patients. |
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المؤلفون: | Teltschik HM; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany., Heinzelmann F; Department of Radiation Oncology, UH of Tuebingen, Tuebingen, Germany., Gruhn B; Children's University Hospital, UH of Jena, Jena, Germany., Feuchtinger T; Dr. von Hauner'sches Kinderspital, Ludwig-Maximilians-Universität Munich, Munich, Germany., Schlegel P; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany., Schumm M; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany., Kremens B; Children's University Hospital, UH of Essen, Essen, Germany., Müller I; Clinic for Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany., Ebinger M; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany., Schwarze CP; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany., Ottinger H; Department of Bone Marrow Transplantation, UH of Essen, Essen, Germany., Zips D; Department of Radiation Oncology, UH of Tuebingen, Tuebingen, Germany., Handgretinger R; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany., Lang P; Children's University Hospital, University Hospital (UH) of Tuebingen, Tuebingen, Germany. peter.lang@med.uni-tuebingen.de. |
المصدر: | British journal of haematology [Br J Haematol] 2016 Oct; Vol. 175 (1), pp. 115-22. Date of Electronic Publication: 2016 Jun 24. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 0372544 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2141 (Electronic) Linking ISSN: 00071048 NLM ISO Abbreviation: Br J Haematol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Oxford : Wiley-Blackwell Original Publication: Oxford : Blackwell Scientific Publications |
مواضيع طبية MeSH: | Haplotypes* , Hematopoietic Stem Cell Transplantation*/adverse effects , Hematopoietic Stem Cell Transplantation*/methods , Transplantation Conditioning*/methods, Graft Rejection/*therapy , HLA Antigens/*genetics, Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Graft Rejection/mortality ; Graft Survival ; Graft vs Host Disease/etiology ; Hematologic Diseases/diagnosis ; Hematologic Diseases/mortality ; Hematologic Diseases/therapy ; Hematopoietic Stem Cell Mobilization/methods ; Humans ; Infant ; Lymphocyte Depletion ; Male ; Retreatment ; Transplantation Chimera ; Transplantation, Homologous ; Treatment Outcome ; Young Adult |
مستخلص: | Graft failure is a life-threatening complication after allogeneic haematopoietic stem cell transplantation (HSCT). We report a cohort of 19 consecutive patients (median age: 8·5 years) with acute leukaemias (n = 14) and non-malignant diseases (n = 5) who experienced graft failure after previous HSCT from matched (n = 3) or haploidentical donors (n = 16) between 2003 and 2012. After total nodal irradiation (TNI)-based reconditioning combined with fludarabine, thiotepa and anti-T cell serotherapy, all patients received T cell-depleted peripheral blood stem cell grafts from a second, haploidentical donor. Median time between graft failure and retransplantation was 14 d (range 7-40). Sustained engraftment (median: 10 d, range 9-32) and complete donor chimerism was observed in all evaluable patients. 5 patients additionally received donor lymphocyte infusions. Graft-versus-host disease (GvHD) grade II and III occurred in 1 patient each (22%); no GvHD grade IV was observed. 2 patients had transient chronic GvHD. The regimen was well tolerated with transient interstitial pneumonitis in one patient. Treatment-related mortality after one year was 11%. Event-free survival and overall survival 3 years after retransplantation were 63% and 68%. Thus, a TNI-based reconditioning regimen followed by transplantation of haploidentical stem cells is an option to rescue patients with graft failure within a short time span and with low toxicity. (© 2016 John Wiley & Sons Ltd.) |
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فهرسة مساهمة: | Keywords: Haploidentical; T cell depletion; children; graft failure; stem cell transplantation |
المشرفين على المادة: | 0 (HLA Antigens) |
تواريخ الأحداث: | Date Created: 20160625 Date Completed: 20170515 Latest Revision: 20181113 |
رمز التحديث: | 20240628 |
مُعرف محوري في PubMed: | PMC5132112 |
DOI: | 10.1111/bjh.14190 |
PMID: | 27341180 |
قاعدة البيانات: | MEDLINE |
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