[HTML][HTML] Peripheral blood hematopoietic stem cells for transplantation of hematological diseases from related, haploidentical donors after reduced-intensity …

K Raj, A Pagliuca, K Bradstock, V Noriega… - Biology of Blood and …, 2014 - Elsevier
K Raj, A Pagliuca, K Bradstock, V Noriega, V Potter, M Streetly, D Mclornan, M Kazmi…
Biology of Blood and Marrow Transplantation, 2014Elsevier
In a multicenter collaboration, we carried out T cell–replete, peripheral blood stem cell
(PBSC) transplantations from related, HLA-haploidentical donors with reduced-intensity
conditioning (RIC) and post-transplantation cyclophosphamide (Cy) as graft-versus-host
disease (GVHD) prophylaxis in 55 patients with high-risk hematologic disorders. Patients
received 2 doses of Cy 50 mg/kg iv on days 3 and 4 after infusion of PBSC (mean, 6.4× 10
6/kg CD34+ cells; mean, 2.0× 10 8/kg CD3+ cells). The median times to neutrophil (500/μL) …
Abstract
In a multicenter collaboration, we carried out T cell–replete, peripheral blood stem cell (PBSC) transplantations from related, HLA-haploidentical donors with reduced-intensity conditioning (RIC) and post-transplantation cyclophosphamide (Cy) as graft-versus-host disease (GVHD) prophylaxis in 55 patients with high-risk hematologic disorders. Patients received 2 doses of Cy 50 mg/kg i.v. on days 3 and 4 after infusion of PBSC (mean, 6.4 × 106/kg CD34+ cells; mean, 2.0 × 108/kg CD3+ cells). The median times to neutrophil (500/μL) and platelet (>20,000/μL) recovery were 17 and 21 days respectively. All but 2 of the patients achieved full engraftment. The 1-year cumulative incidences of grade II and grade III acute GVHD were 53% and 8%, respectively. There were no cases of grade IV GVHD. The 2-year cumulative incidence of chronic GHVD was 18%. With a median follow-up of 509 days, overall survival and event-free survival at 2 years were 48% and 51%, respectively. The 2-year cumulative incidences of nonrelapse mortality and relapse were 23% and 28%, respectively. Our results suggest that PBSC can be substituted safely and effectively for bone marrow as the graft source for haploidentical transplantation after RIC.
Elsevier