Transplantation of CD3/CD19 depleted allografts from haploidentical family donors in paediatric leukaemia
Standard
Transplantation of CD3/CD19 depleted allografts from haploidentical family donors in paediatric leukaemia. / Lang, Peter; Teltschik, Heiko-Manuel; Feuchtinger, Tobias; Müller, Ingo; Pfeiffer, Matthias; Schumm, Michael; Ebinger, Martin; Schwarze, Carl P; Gruhn, Bernd; Schrauder, Andre; Albert, Michael H; Greil, Johann; Urban, Christian; Handgretinger, Rupert.
In: BRIT J HAEMATOL, Vol. 165, No. 5, 01.06.2014, p. 688-98.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Transplantation of CD3/CD19 depleted allografts from haploidentical family donors in paediatric leukaemia
AU - Lang, Peter
AU - Teltschik, Heiko-Manuel
AU - Feuchtinger, Tobias
AU - Müller, Ingo
AU - Pfeiffer, Matthias
AU - Schumm, Michael
AU - Ebinger, Martin
AU - Schwarze, Carl P
AU - Gruhn, Bernd
AU - Schrauder, Andre
AU - Albert, Michael H
AU - Greil, Johann
AU - Urban, Christian
AU - Handgretinger, Rupert
N1 - keine UKE Affiliierung... kann nicht speichern GUW
PY - 2014/6/1
Y1 - 2014/6/1
N2 - Transplantation of T- and B-cell depleted allografts from haploidentical family donors was evaluated within a prospective phase II trial in children with acute lymphoblastic leukaemia, acute myeloid leukaemia and advanced myelodysplastic syndrome (n = 46). 20 patients had active disease; 19 patients received a second or third stem cell transplantation (SCT). Toxicity-reduced conditioning regimens consisted of fludarabine or clofarabine (in active disease only), thiotepa, melphalan and serotherapy. Graft manipulation was carried out with immunomagnetic microbeads. Primary engraftment occurred in 88%, with a median time to reach >1·0 × 10⁹/l leucocytes, >20 × 10⁹/l platelets and >0·1 × 10⁹/l T-cells of 10, 11 and 50 days, respectively. After retransplantation, engraftment occurred in 100%. Acute graft-versus-host disease (GvHD) grade II and III-IV occurred in 20% and 7%, chronic GvHD occurred in 21%. Both conditioning regimens had comparable toxicity. Transplant-related mortality (TRM) was 8% at one year and 20% at 5 years. Event-free survival at 3 years was: 25% (whole group), 46% (first, second or third complete remission [CR], first SCT) vs. 8% (active disease, first SCT) and 20% (second or third SCT, any disease status). This approach allows first or subsequent haploidentical SCTs to be performed with low TRM. Patients in CR may benefit from SCT, whereas the results in patients with active disease were poor.
AB - Transplantation of T- and B-cell depleted allografts from haploidentical family donors was evaluated within a prospective phase II trial in children with acute lymphoblastic leukaemia, acute myeloid leukaemia and advanced myelodysplastic syndrome (n = 46). 20 patients had active disease; 19 patients received a second or third stem cell transplantation (SCT). Toxicity-reduced conditioning regimens consisted of fludarabine or clofarabine (in active disease only), thiotepa, melphalan and serotherapy. Graft manipulation was carried out with immunomagnetic microbeads. Primary engraftment occurred in 88%, with a median time to reach >1·0 × 10⁹/l leucocytes, >20 × 10⁹/l platelets and >0·1 × 10⁹/l T-cells of 10, 11 and 50 days, respectively. After retransplantation, engraftment occurred in 100%. Acute graft-versus-host disease (GvHD) grade II and III-IV occurred in 20% and 7%, chronic GvHD occurred in 21%. Both conditioning regimens had comparable toxicity. Transplant-related mortality (TRM) was 8% at one year and 20% at 5 years. Event-free survival at 3 years was: 25% (whole group), 46% (first, second or third complete remission [CR], first SCT) vs. 8% (active disease, first SCT) and 20% (second or third SCT, any disease status). This approach allows first or subsequent haploidentical SCTs to be performed with low TRM. Patients in CR may benefit from SCT, whereas the results in patients with active disease were poor.
KW - Adolescent
KW - Antigens, CD19
KW - Antigens, CD3
KW - Child
KW - Child, Preschool
KW - Feasibility Studies
KW - Female
KW - Graft Survival
KW - Graft vs Host Disease
KW - Haplotypes
KW - Hematopoietic Stem Cell Mobilization
KW - Hematopoietic Stem Cell Transplantation
KW - Histocompatibility Testing
KW - Humans
KW - Immunocompromised Host
KW - Infant
KW - Leukemia
KW - Leukemia, Myeloid, Acute
KW - Lymphocyte Depletion
KW - Male
KW - Myelodysplastic Syndromes
KW - Opportunistic Infections
KW - Precursor Cell Lymphoblastic Leukemia-Lymphoma
KW - Prospective Studies
KW - Recurrence
KW - Survival Analysis
KW - Transplantation Conditioning
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1111/bjh.12810
DO - 10.1111/bjh.12810
M3 - SCORING: Journal article
C2 - 24588540
VL - 165
SP - 688
EP - 698
JO - BRIT J HAEMATOL
JF - BRIT J HAEMATOL
SN - 0007-1048
IS - 5
ER -