Unrelated donor vs HLA-haploidentical α/β T-cell- and B-cell-depleted HSCT in children with acute leukemia
Unrelated donor vs HLA-haploidentical α/β T-cell- and B-cell-depleted HSCT in children with acute leukemia
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DOI：
10.1182/blood-2018-07-861575
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发表时间：
2018-12-13
期刊：
影响因子：
20.3
通讯作者：
Locatelli, Franco
中科院分区：
文献类型：
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作者：
Bertaina, Alice;Zecca, Marco;Locatelli, Franco
传统上，来自HLA匹配的相关和无关供体（UD）的造血干细胞移植（HSCT）已用于治疗需要同种异体移植的急性白血病（AL）儿童。最近，在单中心研究中，α β T细胞/B细胞耗竭后的HLA半相合HSCT（α β haplo-HSCT）被证明是有效的。在这里，我们报告了对127例匹配的UD（MUD），118例不匹配的UD（MMUD）和98例α β单倍HSCT受者的第一次多中心回顾性分析，这些受者在2010年至2015年期间在13个意大利中心移植。所有这些AL儿童在清髓性预处理方案后形态缓解时进行移植。UD-HSCT和α β haplo-HSCT组中各有2%的移植物失败。在MUD和MMUD-HSCT受者中，II级至IV级和III级至IV级急性移植物抗宿主病（GVHD）的累积发生率分别为35%和44%，6%和18%，而α β单倍HSCT受者分别为16%和0%（P
Traditionally, hematopoietic stem cell transplantation (HSCT) from both HLA-matched related and unrelated donors (UD) has been used for treating children with acute leukemia (AL) in need of an allograft. Recently, HLA-haploidentical HSCT after alpha beta T-cell/B-cell depletion (alpha beta haplo-HSCT) was shown to be effective in single-center studies. Here, we report the first multicenter retrospective analysis of 127 matched UD (MUD), 118 mismatched UD (MMUD), and 98 alpha beta haplo-HSCT recipients, transplanted between 2010 and 2015, in 13 Italian centers. All these AL children were transplanted in morphological remission after a myeloablative conditioning regimen. Graft failure occurred in 2% each of UD-HSCT and alpha beta haplo-HSCT groups. In MUD vs MMUD-HSCT recipients, the cumulative incidence of grade II to IV and grade III to IV acute graft-versus-host disease (GVHD) was 35% vs 44% and 6% vs 18%, respectively, compared with 16% and 0% in alpha beta haplo-HSCT recipients (P