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Feasible Outcomes of T-cell Replete Haploidentical Stem Cell Transplantation with Reduced Intensity Conditioning in Patients with Myelodysplastic Syndrome.

著者 Shin SH , Kim JH , Jeon YW , Yoon JH , Yahng SA , Lee SE , Choi YS , Kim DY , Lee JH , Lee S , Kim HJ , Min CK , Lee JW , Lee KH , Min WS , Kim YJ , Lee JH この記事をPubMed上で見るPubMedで表示
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Even with the recent optimization of haploidentical stem cell transplantation (SCT), its role for patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia evolving from MDS (sAML) should be validated. We analyzed the outcomes of consecutive 60 patients with MDS or sAML, who received T-cell replete haploidentical SCT after reduced-intensity conditioning with fludarabine, busulfan, and rabbit anti-thymocyte globuline ± 800 cGy total body irradiation. Patients achieved a rapid neutrophil engraftment, after a median of 12 days (range, 8-23), and an early immune reconstitution without high incidences of acute graft-versus-host disease (GVHD) II-IV and chronic GVHD (36.7% and 48.3%, respectively). After a median follow-up of 4 years, incidences of relapse, non-relapse mortality and rates of overall survival and disease-free survival were 34.8%, 23.3%, 46.8%, and 41.9%, respectively. In multivariate analysis, the disease status at peak was a significant predictor for relapse (lower-risk MDS vs higher-risk MDS or sAML; HR 5.69, 95% CI 1.45-22.29; P=0.013) and disease-free survival (HR 4.44, 95% CI 1.14-17.34; P=0.032). Chronic GVHD was an additional significant predictor for relapse (no vs yes; HR 2.87, 95% CI 1.03-7.51; P=0.043). Our T-cell replete haploidentical SCT may be a feasible option for patients with MDS and sAML without conventional donors.
PMID: 25459640 [PubMed - as supplied by publisher]
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