دورية أكاديمية

Cytokine-mobilized allogeneic peripheral blood stem cell transplants in children result in rapid engraftment and a high incidence of chronic GVHD.

التفاصيل البيبلوغرافية
العنوان: Cytokine-mobilized allogeneic peripheral blood stem cell transplants in children result in rapid engraftment and a high incidence of chronic GVHD.
المؤلفون: Levine, J E, Wiley, J, Kletzel, M, Yanik, G, Hutchinson, R J, Koehler, M, Neudorf, S
المصدر: Bone Marrow Transplantation; 1/1/2000, Vol. 25 Issue 1, p13, 6p
مصطلحات موضوعية: CYTOKINES, STEM cells, CELL transplantation, CHILDREN
مستخلص: Between October 1995 and October 1998, 24 children aged 9 months to 17 years (median 11 years) underwent cytokine-mobilized allogeneic peripheral blood stem cell (PBSC) transplantation for treatment of hematological disorders. All of the transplants were the first allogeneic transplant for the recipient. Twenty patients were transplanted for hematological malignancies (ALL = 8, AML = 6, CML = 4, MDS = 2) and four patients were transplanted for non-malignant disease (thalassemia major = 2, Wiskott–Aldrich syndrome = 1, Kostmann’s syndrome = 1). Nineteen donors were HLA-identical siblings, four were HLA-matched or single antigen mismatched parents, and one was a syngeneic transplant. Donors aged 8 to 38 years (median 15 years, 14 donors <18 years) received g-csf 10 μg/kg/day subcutaneously beginning 4 days before pbsc collection and were submitted to one to three leukapheresis collections. the median cd34+ cell yield was 7.8 × 106 cells/kg recipient body weight. all patients achieved an anc >0.5 × 109/l after a median of 13 days (range 10–21). Twenty-three patients eventually achieved platelet transfusion independence. One patient died on day 63 without ever achieving platelet transfusion independence. Four patients received platelet transfusions to maintain a platelet count well above 20 × 109/l due to bleeding complications. Of the 19 evaluable patients, the median time to a non-transfused platelet count of 20 × 109/l was 12 days (range 0–44). Ten of 23 at-risk patients developed acute GVHD grades II to IV, with grades III to IV in four patients. Twelve of 19 patients followed for at least 100 days have developed chronic GVHD (extensive = 2, limited = 10) with an actuarial risk of chronic GVHD of 75% at 1 year. The Kaplan–Meier estimate of event-free survival is 65% at 2 years. Four patients died (GVHD = 3, VOD = 1), three patients relapsed, and... [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:02683369
DOI:10.1038/sj.bmt.1702081