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Haploidentical Transplantation Using T-Cell Replete Peripheral Blood Stem Cells and Myeloablative Conditioning in Patients with High-Risk Hematologic Malignancies Who Lack Conventional Donors Is Well Tolerated and Produces Excellent Relapse-Free Survival: Results of A Prospective Phase II Trial.

著者 Solomon SR , Sizemore CA , Sanacore M , Zhang X , Brown S , Holland HK , Morris LE , Bashey A この記事をPubMed上で見るPubMedで表示
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Blood and Marrow Transplant Program at Northside Hospital; Atlanta, Georgia.

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Haploidentical hematopoietic stem cell transplantation (HSCT) provides an opportunity for nearly all patients to benefit from HSCT. We conducted a trial of haploidentical T-replete allografting using a busulfan-based myeloablative preparative regimen, peripheral blood stem cells (PBSC) as the graft source, and post-transplant cyclophosphamide (Cy). Eligibility was limited to patients at high risk of relapse following nonmyeloablative haploidentical BMT. Twenty patients were enrolled in the study (eleven with relapsed/refractory disease; 9 transplanted in remission and considered standard risk). Donor engraftment occurred in all 20 patients with full donor T cell and myeloid chimerism by Day +30. The cumulative incidence of grades II-IV and III-IV aGVHD was 30% and 10%, respectively. The cumulative incidence of cGVHD was 35%. Non-relapse mortality (NRM) at 100 days and 1 yr was 10% for all patients and 0% for standard risk patients. With a median follow-up of 20 months, the estimated one year overall and disease-free survival was 69% and 50%, respectively for all patients; 88% and 67% for standard risk patients. Myeloablative haploidentical HSCT is associated with excellent rates of engraftment, GVHD, NRM and DFS, and is a valid option in patients with high-risk malignancies who lack timely access to a conventional donor.
PMID: 22863841 [PubMed - as supplied by publisher]
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