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Bone marrow compared to peripheral blood stem cells for haploidentical transplantation with a non-myeloablative conditioning regimen and post-transplant cyclophosphamide.

著者 Castagna L , Crocchiolo R , Furst S , Bramanti S , El Cheikh J , Sarina B , Granata A , Mauro E , Faucher C , Mohty B , Harbi S , Chabannon C , Carlo-Stella C , Santoro A , Blaise D この記事をPubMed上で見るPubMedで表示
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Recently, the administration of high-dose cyclophosphamide (Cy) after T cell-replete haploidentical stem cell infusion has been reported to be feasible and effective. In the original study, bone marrow (BM) was used as the source of stem cells. Here, we retrospectively analyzed the use of BM versus peripheral blood stem cells (PBSCs) in a cohort of patients receiving haploidentical T cell-replete transplantation after a non-myeloablative conditioning (NMAC) regimen with post-infusion Cy. In the PBSC vs. BM groups, the incidence of acute graft-versus-host disease (GVHD) was 33% vs. 25%, respectively, and the incidence of chronic GVHD was 13% vs. 13%, respectively. The median time to achieve a safe and unsupported absolute neutrophil or platelet count was 20 vs. 21 days and 27 vs. 29 days, respectively. The incidence of engraftment was also similar in the two cohorts. The 1-year non-relapse mortality rate was 12% vs. 22%, respectively (p=0.96). Finally, nonsignificant differences in survival were observed. In conclusion, the use of PBSCs instead of BM after T-cell replete haploidentical transplantation did not appear to be detrimental in terms of either GVHD or engraftment rate. PBSCs could be a valid alternative to BM after transplantation from a haploidentical donor using post-infusion Cy.
PMID: 24530426 [PubMed - as supplied by publisher]
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