Haploidentical hematopoietic stem cell transplantation in hematologic malignancies with G-CSF mobilized bone marrow plus peripheral blood stem cells grafts without T cell depletion: a single center report of 29 cases

• Published in: Leukemia & lymphoma 2012-04, Vol.53 (4), p.654-659
• Main Authors: Wang, Heng-Xiang, Yan, Hong-Min, Wang, Zhi-Dong, Xue, Mei, Liu, Jing, Guo, Zi-Kuan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Animals; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Child; Female; Graft vs Host Disease - etiology; Graft vs Host Disease - prevention & control; Granulocyte Colony-Stimulating Factor - pharmacology; GVHD; haplotype; Haplotypes - genetics; Hematologic Neoplasms - genetics; Hematologic Neoplasms - immunology; Hematologic Neoplasms - therapy; Hematopoietic Stem Cell Mobilization - methods; hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - methods; Histocompatibility - genetics; Humans; Leukocyte Count; Lymphocyte Depletion; Male; Middle Aged; myeloablative therapy; Peripheral Blood Stem Cell Transplantation - adverse effects; Peripheral Blood Stem Cell Transplantation - methods; Platelet Count; Rabbits; Survival Analysis; Transplantation Conditioning - methods; Treatment Outcome; Whole-Body Irradiation; Young Adult
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428194.2011.624225

Abstract Haploidentical Hematopoietic stem cell transplantation (Haplo-HSCT) has provided an alternative option since virtually all patients have an immediately available donor. Here, we report the results of Haplo-HSCT with granulocyte-colony-stimulating factor (G-CSF) mobilized bone marrow grafts plus peripheral blood stem cells as the grafts without T-cell depletion. Twenty-nine patients with the mean age of 27.27 years (ranging from 15 to 51 years) were enrolled in this study, and 10 cases were in high risk status. The patients received myeloablative preconditioning with or without total body irradiation and acute graft-versus-host disease (GVHD) prophylaxis consisting of basiliximab, cyclosporine A, methotrexate, mycophenolate mofetil and a rabbit anti-thymocyte globulin. All the patients attained successful neutrophil and platelet recovery. The mean times for neutrophil and platelet recovery were 17.1 and 20.9 days, respectively. During the follow-up at a median time of 30.69 months (ranging from 3 to 76 months), nine patients developed aGVHD grade II-IV, including two developed grade III-IV GVHD after donor lymphocyte infusion. The incidence of cGVHD was 48.3%. 13 patients died within the first two years after transplantation, and the total disease-free survival rate longer than 2 years was 55.2%. These results suggest that G-CSF-primed bone marrow plus peripheral blood stem cell grafts are an appropriate stem cell source for Haplo-HSCT and large scale investigations are needed to confirm this protocol.