Poor graft function after T cell-depleted allogeneic hematopoietic stem cell transplant

被引:6
作者
Reich-Slotky, Ronit [1 ]
Al-Mulla, Naima [2 ]
Hafez, Rania [3 ]
Segovia-Gomez, Javier [4 ]
Goel, Ruchika [5 ,6 ]
Mayer, Sebastian [7 ]
Phillips, Adrienne [7 ]
Shore, Tsiporah B. [7 ]
Hsu Jing-Mei [7 ]
Hsu, Yen-Michael Sheng [7 ]
Vasovic, Ljiljana V. [7 ]
Cushing, Melissa M. [7 ]
Gergis, Usama [7 ]
机构
[1] Hackensack Univ, Med Ctr, Hackensack, NJ USA
[2] Hamad Med Corp, Doha, Qatar
[3] Assiut Univ, Sch Med, Assiute, Egypt
[4] Cent Mil Hosp Bogota, Bogota, Colombia
[5] Johns Hopkins Univ, Dept Pathol, Div Transfus Med, Baltimore, MD USA
[6] Simmons Canc Inst, SIU Sch Med, Springfield, IL USA
[7] Weill Cornell Med Coll, Pathol, New York Presbyterian Hosp, New York, NY USA
关键词
PGF; delayed hematopoietic recovery; poor graft function; CORD BLOOD TRANSPLANTATION; BONE-MARROW; ABO INCOMPATIBILITY; PLATELET RECOVERY; HOST-DISEASE; DONOR; HLA; IMPACT; OUTCOMES; APLASIA;
D O I
10.1080/10428194.2020.1789622
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PGF implies persistent cytopenia in the presence of predominant donor chimerism. We examined contributors to PGF in 104 HCT recipients who survived >= 100 days without relapse or major complications. Surrogate parameters for PGF were: Hg <10 g/dl, RBC transfusion dependence, platelet count <20 x 10(9)/L or ANC < 0.5 x 10(9)/L. All patients received T cell depletion with alemtuzumab or ATG. The 2-year OS and PFS probabilities were 66%, 95%CI (56 - 75%) and 51%, 95%CI (41-60%) respectively. Fifty-four patients (52%) met one or more PGF criteria. There was significant association between major ABO incompatibility and platelet <20 x 109/L (OR = 4.7, 95%CI 1.05-21.26,p = .043), acute GVHD and Hg <10 g/dl (OR 3.7, 95%CI 1.4-9.6,p = .005) and CMV viremia and ANC < 0.5 x 10(9)/L (OR 3.0, 95% CI 1.0, 8.7,p = .043). NRM was significantly higher in the PGF group compared to patients with adequate graft function (45.5% vs 16.7%,p = .014).
引用
收藏
页码:2894 / 2899
页数:6
相关论文
共 37 条
[1]  
ANASETTI C, 1989, BLOOD, V73, P1054
[2]  
Bar BMAM, 1995, BONE MARROW TRANSPL, V16, P793
[3]   How I treat: the selection and acquisition of unrelated cord blood grafts [J].
Barker, Juliet N. ;
Byam, Courtney ;
Scaradavou, Andromachi .
BLOOD, 2011, 117 (08) :2332-2339
[4]  
Benjamin R J, 1998, Biol Blood Marrow Transplant, V4, P151
[5]   Delayed donor red cell chimerism and pure red cell aplasia following major ABO-incompatible nonmyeloablative hematopoietic stem cell transplantation [J].
Bolan, CD ;
Leitman, SF ;
Griffith, LM ;
Wesley, RA ;
Procter, JL ;
Stroncek, DF ;
Barrett, AJ ;
Childs, RW .
BLOOD, 2001, 98 (06) :1687-1694
[6]   Secondary failure of platelet recovery after hematopoietic stem cell transplantation [J].
Bruno, B ;
Gooley, T ;
Sullivan, KM ;
Davis, C ;
Bensinger, WI ;
Storb, R ;
Nash, RA .
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, 2001, 7 (03) :154-162
[7]   Alternative donor transplantation after reduced intensity conditioning: results of parallel phase 2 trials using partially HLA-mismatched related bone marrow or unrelated double umbilical cord blood grafts [J].
Brunstein, Claudio G. ;
Fuchs, Ephraim J. ;
Carter, Shelly L. ;
Karanes, Chatchada ;
Costa, Luciano J. ;
Wu, Juan ;
Devine, Steven M. ;
Wingard, John R. ;
Aljitawi, Omar S. ;
Cutler, Corey S. ;
Jagasia, Madan H. ;
Ballen, Karen K. ;
Eapen, Mary ;
O'Donnell, Paul V. .
BLOOD, 2011, 118 (02) :282-288
[8]   Infusion of ex vivo expanded T regulatory cells in adults transplanted with umbilical cord blood: safety profile and detection kinetics [J].
Brunstein, Claudio G. ;
Miller, Jeffrey S. ;
Cao, Qing ;
McKenna, David H. ;
Hippen, Keli L. ;
Curtsinger, Julie ;
DeFor, Todd ;
Levine, Bruce L. ;
June, Carl H. ;
Rubinstein, Pablo ;
McGlave, Philip B. ;
Blazar, Bruce R. ;
Wagner, John E. .
BLOOD, 2011, 117 (03) :1061-1070
[9]   Allogeneic hematopoietic cell transplantation for hematologic malignancy: relative risks and benefits of double umbilical cord blood [J].
Brunstein, Claudio G. ;
Gutman, Jonathan A. ;
Weisdorf, Daniel J. ;
Woolfrey, Ann E. ;
DeFor, Todd E. ;
Gooley, Theodore A. ;
Verneris, Michael R. ;
Appelbaum, Frederick R. ;
Wagner, John E. ;
Delaney, Colleen .
BLOOD, 2010, 116 (22) :4693-4699
[10]   Impact of ABO incompatibility on allogeneic peripheral blood progenitor cell transplantation after reduced intensity conditioning [J].
Canals, C ;
Muñiz-Díaz, E ;
Martínez, C ;
Martino, R ;
Moreno, I ;
Ramos, A ;
Arilla, M ;
Boto, N ;
Pastoret, C ;
Remacha, A ;
Sierra, J ;
Madoz, P .
TRANSFUSION, 2004, 44 (11) :1603-1611