Outcome of Non-T-Cell-Depleted HLA-Haploidentical Hematopoietic Stem Cell Transplantation from Family Donors in Children and Adolescents

被引：0

作者：

Takao Yoshihara

Keiko Okada

Michihiro Kobayashi

Atsushi Kikuta

Koji Kato

Naoto Adachi

Akira Kikuchi

Hiroyuki Ishida

Yasuzou Hirota

Hiroshi Kuroda

Yoshihisa Nagatoshi

Takeshi Inukai

Kazutoshi Koike

Hisato Kigasawa

Hiroshi Yagasaki

Kiriko Tokuda

Tomoko Kishimoto

Takahide Nakano

Naoto Fujita

Hiroaki Goto

Yozo Nakazawa

Hirokazu Kanegane

Akinobu Matsuzaki

Yuko Osugi

Daiichiro Hasegawa

Nobuhiko Uoshima

Kazuhiro Nakamura

Masahiro Tsuchida

Ryuhei Tanaka

Arata Watanabe

Hiromasa Yabe

机构：

[1] Matsushita Memorial Hospital,Department of Pediatrics

[2] Osaka University Graduate School of Medicine,Graduate School of Medicine

[3] Kyoto University,Faculty of Medicine

[4] Fukushima Medical University,Graduate School of Medicine

[5] Japanese Red Cross Nagoya First Hospital,Faculty of Medicine

[6] Kumamoto University Graduate School of Medical Sciences,Graduate School of Medical Sciences

[7] Saitama Children’s Medical Center,Department of Hematology

[8] Show a University Fujigaoka Hospital,undefined

[9] Yokohama,undefined

[10] Kyoto City Hospital,undefined

[11] National Kyushu Cancer Center,undefined

[12] Fukuoka,undefined

[13] University of Yamanashi,undefined

[14] Ibaraki Children’s Hospital,undefined

[15] Kanagawa Children’s Medical Center,undefined

[16] Nagoya University,undefined

[17] Ehime University School of Medicine,undefined

[18] Nara Medical University,undefined

[19] Kansai Medical University,undefined

[20] Hiroshima Red-Cross and Atomic-Bomb Survivors Hospital,undefined

[21] Yokohama City University School of Medicine,undefined

[22] Shinshu University School of Medicine,undefined

[23] University of Toyama,undefined

[24] Kyushu University,undefined

[25] Osaka City General Hospital,undefined

[26] Hyogo Prefectural Kobe Children’s Hospital,undefined

[27] Matsushita Memorial Hospital,undefined

[28] Hiroshima University School of Medicine,undefined

[29] Saitama Medical School Hospital,undefined

[30] Nakadori General Hospital,undefined

[31] Tokai University School of Medicine,undefined

来源：

International Journal of Hematology | 2007年 / 85卷

关键词：

Hematopoietic stem cell transplantation; HLA-haploidentical donor; Noninherited maternal antigen (NIMA); Long-term fetomaternal microchimerism; Childhood;

D O I：

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学科分类号：

摘要：

Non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation (SCT) from family members has been reported, but its effectiveness and safety are not fully known. In this study, we examined the outcomes of 83 children and adolescents with nonmalignant (n = 11) or malignant (n = 72) disorders who underwent SCT mismatched at 2 or 3 HLA loci, either from the mother (n = 56), a noninherited maternal antigen (NIMA)-mismatched sibling (n = 14), or the father/a noninherited paternal antigen (NIPA)-mismatched sibling (n = 13). Engraftment was satisfactory. Severe (grade III-IV) acute graft-versus-host disease (GVHD) was noted only in malignant disease, with an incidence of 21 of 64 evaluable patients. GVHD prophylaxis with a combination of tacrolimus and methotrexate was significantly associated with a lower risk of severe acute GVHD, compared with other types of prophylaxis(P = .04). Nine of 11 patients with nonmalignant disease and 29 of 72 patients with malignant disease were alive at a median follow-up of 26 months (range, 4-57 months). Outcomes were not significantly different among the 3 donor groups (mother versus NIMA-mismatched sibling versus father/NIPA-mismatched sibling) for the malignancy disorders. Our results indicate that non-T-cell-depleted HLA-haploidentical SCT may be feasible, with appropriate GVHD prophylaxis, for young recipients who lack immediate access to a conventional stem cell source.

引用

页码：246 / 255

页数：9

共 122 条

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