Comprehensive up-to-date analysis on TCRαβ/CD19-depleted hematopoietic stem cell transplantation in pediatric hematological malignancies

被引:0
作者
Abdelgawad, Hussien Ahmed H. [1 ,2 ]
Aboeldahab, Heba [3 ,4 ]
Belal, Mohamed Mohamed [5 ]
Bashir, Mohamed Nabih [5 ]
Miller, Holly K. [1 ,2 ,6 ]
Handgretinger, Rupert [7 ,8 ]
Otto, Mario [1 ,2 ]
机构
[1] Phoenix Childrens Hosp, Ctr Canc & Blood Disorders, Phoenix, AZ 85016 USA
[2] Univ Arizona, Dept Child Hlth, Coll Med, Phoenix, AZ USA
[3] Alexandria Univ, Med Res Inst, Biomed Informat & Med Stat Dept, Alexandria, Egypt
[4] El Gomhoria Gen Hosp, MOHP, Clin Res Dept, Alexandria, Egypt
[5] Alexandria Univ, Fac Med, Alexandria, Egypt
[6] Mayo Clin, Div Hematol & Oncol, Scottsdale, AZ USA
[7] Childrens Univ Hosp, Dept Hematol Oncol, Tubingen, Germany
[8] NATL UNIV SINGAPORE, DEPT PEDIAT, SINGAPORE, Singapore
关键词
TCR alpha beta +/CD19+; HSCT; Hematological Mmalignancies; TOTAL-BODY IRRADIATION; ACUTE MYELOID-LEUKEMIA; HAPLOIDENTICAL TRANSPLANTATION; GRAFT FAILURE; DEPLETED HSCT; CHILDREN; ALPHA/BETA; ENGRAFTMENT; SURVIVAL; OUTCOMES;
D O I
10.1016/j.trim.2025.102220
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
This meta-analysis assesses the efficacy of TCR alpha beta+/CD19+ depleted hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematological malignancies, bridging the gap in the heterogeneous results of published studies. We analyzed post-HSCT complications and survival outcomes in 1068 children across 14 studies, using both aggregated and patient-level data from acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) and acute lymphoblastic leukemia (ALL) studies, employing the IPDfromKM technique for time-toevent data reconstruction. The analysis reveals a 95 % engraftment success rate (95 % CI: 93-97) and 6-year overall survival and disease-free survival (DFS) rates of 67.2 % and 66.3 %, respectively, with no significant differences in DFS between haploidentical and unrelated donors (hazard ratio = 0.9, 95 % CI: 0.53-1.55). Acute graft-versus-host disease (GvHD) grades III-IV and chronic GvHD incidences were 8 % (95 % CI: 6-11) and 17 % (95 % CI: 10-27). The relapse rate was 27 % (95 % CI: 21-33), with relapse-related mortality at 21 % (95 % CI: 15-28) and HSCT-related mortality at 12 % (95 % CI: 7-19). Relapse was significantly lower in patients (mostly ALL) receiving total body irradiation (risk ratio = 0.53, P = 0.04). These findings underscore TCR alpha beta/CD19depleted HSCT as a valuable option for patients without HLA-matched donors, highlighting the need for larger, multicenter studies.
引用
收藏
页数:13
相关论文
共 56 条
[1]   Immune Reconstitution Following TCRαβ/CD19-Depleted Hematopoietic Cell Transplantation for Hematologic Malignancy in Pediatric Patients [J].
Arnold, Danielle E. ;
MacMath, Derek ;
Seif, Alix E. ;
Heimall, Jennifer R. ;
Wang, Yongping ;
Monos, Dimitri ;
Grupp, Stephan A. ;
Bunin, Nancy J. .
TRANSPLANTATION AND CELLULAR THERAPY, 2021, 27 (02) :169.e1-169.e9
[2]   Impact of γδ T cells on clinical outcome of hematopoietic stem cell transplantation: systematic review and meta-analysis [J].
Arruda, Lucas C. M. ;
Gaballa, Ahmed ;
Uhlin, Michael .
BLOOD ADVANCES, 2019, 3 (21) :3436-3448
[3]   SUCCESSFUL ENGRAFTMENT OF T-CELL-DEPLETED HAPLOIDENTICAL 3-LOCI INCOMPATIBLE TRANSPLANTS IN LEUKEMIA PATIENTS BY ADDITION OF RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR-MOBILIZED PERIPHERAL-BLOOD PROGENITOR CELLS TO BONE-MARROW INOCULUM [J].
AVERSA, F ;
TABILIO, A ;
TERENZI, A ;
VELARDI, A ;
FALZETTI, F ;
GIANNONI, C ;
IACUCCI, R ;
ZEI, T ;
MARTELLI, MP ;
GAMBELUNGHE, C ;
ROSSETTI, M ;
CAPUTO, P ;
LATINI, P ;
ARISTEI, C ;
RAYMONDI, C ;
REISNER, Y ;
MARTELLI, MF .
BLOOD, 1994, 84 (11) :3948-3955
[4]   How to perform a meta-analysis with R: a practical tutorial [J].
Balduzzi, Sara ;
Ruecker, Gerta ;
Schwarzer, Guido .
EVIDENCE-BASED MENTAL HEALTH, 2019, 22 (04) :153-160
[5]   Unrelated donor vs HLA-haploidentical α/β T-cell- and B-cell-depleted HSCT in children with acute leukemia [J].
Bertaina, Alice ;
Zecca, Marco ;
Buldini, Barbara ;
Sacchi, Nicoletta ;
Algeri, Mattia ;
Saglio, Francesco ;
Perotti, Cesare ;
Gallina, Anna Maria ;
Bertaina, Valentina ;
Lanino, Edoardo ;
Prete, Arcangelo ;
Barberi, Walter ;
Tumino, Manuela ;
Favre, Claudio ;
Cesaro, Simone ;
Del Bufalo, Francesca ;
Ripaldi, Mimmo ;
Boghen, Stella ;
Casazza, Gabriella ;
Rabusin, Marco ;
Balduzzi, Adriana ;
Fagioli, Franca ;
Pagliara, Daria ;
Locatelli, Franco .
BLOOD, 2018, 132 (24) :2594-2607
[6]   On Modeling Human Leukocyte Antigen-Identical Sibling Match Probability for Allogeneic Hematopoietic Cell Transplantation: Estimating the Need for an Unrelated Donor Source [J].
Besse, Kelsey ;
Maiers, Martin ;
Confer, Dennis ;
Albrecht, Mark .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2016, 22 (03) :410-417
[7]   A large-scale method for the selective depletion of αβ T lymphocytes from PBSC for allogeneic transplantation [J].
Chaleff, S. ;
Otto, M. ;
Barfield, R. C. ;
Leimig, T. ;
Iyengar, R. ;
Martin, J. ;
Holiday, M. ;
Houston, J. ;
Geiger, T. ;
Huppert, V. ;
Handgretinger, R. .
CYTOTHERAPY, 2007, 9 (08) :746-754
[8]  
Constantinescu V., 2021, Download scanit: softpedia
[9]   αβ+/CD19+-depleted haploidentical stem cell transplantation for children with acute leukemia: Is there a protective effect of increased γδ+ T-cell content in the graft? [J].
Dadi, Gal ;
Jacoby, Elad ;
Adam, Etai ;
Hutt, Daphna ;
Varda-Bloom, Nira ;
Bielorai, Bella ;
Toren, Amos .
PEDIATRIC TRANSPLANTATION, 2023, 27 (05)
[10]   Influence of trial sample size on treatment effect estimates: meta-epidemiological study [J].
Dechartres, Agnes ;
Trinquart, Ludovic ;
Boutron, Isabelle ;
Ravaud, Philippe .
BMJ-BRITISH MEDICAL JOURNAL, 2013, 346