Skip to main content

Advertisement

Log in

Haploidentical hematopoietic stem cell transplantation following myeloablative conditioning regimens in hematologic diseases with G-CSF-mobilized peripheral blood stem cells grafts without T cell depletion: a single center report of 38 cases

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

Many Chinese patients with hematologic diseases, who need allogeneic hematopoietic stem cell transplantation (HSCT), lack a human leukocyte antigen-matched donor. To save these patients and to avoid collecting donor bone marrow graft, we adopted haploidentical peripheral blood HSCT with granulocyte colony stimulating factor (G-CSF) mobilized peripheral blood stem cells as the grafts without ex vivo T cell depletion. Thirty-eight patients were enrolled, and they received myeloablative preconditioning. Thirty-five patients attained a successful neutrophil and platelet recovery. The median time for the neutrophil recovery was 16 days (range of 10–23 days), and the median time for the platelet recovery was 19 days (range of 10–66 days). During the follow-up at a median time of 33.1 weeks (range of 1.1–412.6 weeks), eleven (28.9 %) patients developed aGVHD grade I–II and seven (18.4 %) patients developed aGVHD grade III–IV. The incidence of cGVHD was 27.6 %, and nine (23.7 %) patients died within the first 100 days after transplantation. The cumulative survival proportions at 1 and 2 years were 52.51 ± 8.57 % and 43.76 ± 9.11 %, respectively. These results suggested that the G-CSF-primed peripheral blood stem cell grafts, without in vitro T cell depletion, could be an appropriate stem cell source for Haplo-HSCT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Guinan EC, Boussiotis VA, Neuberg D, Brennan LL, Hirano N, Nadler LM, et al. Transplantation of anergic histoincompatible bone marrow allografts. N Engl J Med. 1999;340(22):1704.

    Article  CAS  PubMed  Google Scholar 

  2. Goldman FD, Rumelhart SL, DeAlacron P, Holida MD, Lee NF, Miller J, et al. Poor outcome in children with refractory/relapsed leukemia undergoing bone marrow transplantation with mismatched family member donors. Bone Marrow Transpl. 2000;25(9):943.

    Article  CAS  Google Scholar 

  3. Huang XJ, Chang YJ, Zhao XY. Maintaining hyporesponsiveness and polarization potential of T cells after in vitro mixture of G-CSF mobilized peripheral blood grafts and G-CSF primed bone marrow grafts in different proportions. Transpl Immunol. 2007;17(3):193.

    Article  CAS  PubMed  Google Scholar 

  4. Xu LP, Liu KY, Liu DH, Chen H, Han W, Chen YH, et al. The inferiority of G-PB to rhG-CSF-mobilized blood and marrow grafts as a stem cell source in patients with high-risk acute leukemia who underwent unmanipulated HLA-mismatched/haploidentical transplantation: a comparative analysis. Bone Marrow Transpl. 2010;45(6):985.

    Article  CAS  Google Scholar 

  5. Cottler-Fox M, Cipolone K, Yu M, Berenson R, O’Shaughnessy J, Dunbar C. Positive selection of CD34+ hematopoietic cells using an immunoaffinity column results in T cell-depletion equivalent to elutriation. Exp Hematol. 1995;23(4):320.

    CAS  PubMed  Google Scholar 

  6. Peters C, Matthes-Martin S, Fritsch G, Holter W, Lion T, Witt V, et al. Transplantation of highly purified peripheral blood CD34+ cells from HLA-mismatched parental donors in 14 children: evaluation of early monitoring of engraftment. Leukemia. 1999;13(12):2070.

    Article  CAS  PubMed  Google Scholar 

  7. Ciceri F, Labopin M, Aversa F, Rowe JM, Bunjes D, Lewalle P, et al. A survey of fully haploidentical hematopoietic stem cell transplantation in adults with high-risk acute leukemia: a risk factor analysis of outcomes for patients in remission at transplantation. Blood. 2008;112(9):3574.

    Article  CAS  PubMed  Google Scholar 

  8. Lu DP, Dong L, Wu T, Huang XJ, Zhang MJ, Han W, et al. Conditioning including antithymocyte globulin followed by unmanipulated HLA-mismatched/haploidentical blood and marrow transplantation can achieve comparable outcomes with HLA-identical sibling transplantation. Blood. 2006;107(8):3065.

    Article  CAS  PubMed  Google Scholar 

  9. Basara N, Baurmann H, Kolbe K, Yaman A, Labopin M, Burchardt A, et al. Antithymocyte globulin for the prevention of graft-versus-host disease after unrelated hematopoietic stem cell transplantation for acute myeloid leukemia: results from the multicenter German cooperative study group. Bone Marrow Transpl. 2005;35(10):1011.

    Article  CAS  Google Scholar 

  10. Bacigalupo A. Antilymphocyte/thymocyte globulin for graft versus host disease prophylaxis: efficacy and side effects. Bone Marrow Transpl. 2005;35(3):225.

    Article  CAS  Google Scholar 

  11. Gorin NC, Labopin M, Rocha V, Arcese W, Beksac M, Gluckman E, et al. Marrow versus peripheral blood for geno-identical allogeneic stem cell transplantation in acute myelocytic leukemia: influence of dose and stem cell source shows better outcome with rich marrow. Blood. 2003;102(8):3043.

    Article  CAS  PubMed  Google Scholar 

  12. Handgretinger R, Lang P. The history and future prospective of haplo-identical stem cell transplantation. Cytotherapy. 2008;10(5):443.

    Article  CAS  PubMed  Google Scholar 

  13. Wang HX, Yan HM, Wang ZD, Xue M, Liu J, Guo ZK. 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. Leuk Lymphoma. 2012;53(4):654.

    Article  CAS  PubMed  Google Scholar 

  14. Kircher B, Latzer K, Gastl G, Nachbaur D. Comparative in vitro study of the immunomodulatory activity of humanized and chimeric anti-CD25 monoclonal antibodies. Clin Exp Immunol. 2003;134(3):426.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Chen HR, Ji SQ, Wang HX, Yan HM, Zhu L, Liu J, et al. Humanized anti-CD25 monoclonal antibody for prophylaxis of graft-vs-host disease (GVHD) in haploidentical bone marrow transplantation without ex vivo T-cell depletion. Exp Hematol. 2003;31(11):1019.

    Article  CAS  PubMed  Google Scholar 

  16. Weiden PL, Sullivan KM, Flournoy N, Storb R, Thomas ED. Antileukemic effect of chronic graft-versus-host disease: contribution to improved survival after allogeneic marrow transplantation. N Engl J Med. 1981;304(25):1529.

    Article  CAS  PubMed  Google Scholar 

  17. Ringden O, Hermans J, Labopin M, Apperley J, Gorin NC, Gratwohl A. The highest leukaemia-free survival after allogeneic bone marrow transplantation is seen in patients with grade I acute graft-versus-host disease. Acute and chronic leukaemia Working Parties of the European Group for blood and marrow transplantation (EBMT). Leuk Lymphoma. 1996;24(1–2):71.

    Article  CAS  PubMed  Google Scholar 

  18. Huang W, Li H, Gao C, Bo J, Wang Q, Zhao Y, et al. Unmanipulated HLA-mismatched/haploidentical peripheral blood stem cell transplantation for high-risk hematologic malignancies. Transfusion. 2012;52(6):1354.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported in part by the Program for Development of Innovative Research Team in the First Affiliated Hospital of NJMU; A Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions; the National Natural Science Foundation of China (81000216); Research Special Fund of the Ministry of Health for Public Service Sectors.

Conflict of interest

The authors declare that they have no conflict of interests.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Han-Xin Wu or Si-xuan Qian.

Additional information

Rui-Nan Lu and Kou-Rong Miao have contributed equally to this paper.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lu, RN., Miao, KR., Zhang, R. et al. Haploidentical hematopoietic stem cell transplantation following myeloablative conditioning regimens in hematologic diseases with G-CSF-mobilized peripheral blood stem cells grafts without T cell depletion: a single center report of 38 cases. Med Oncol 31, 81 (2014). https://doi.org/10.1007/s12032-014-0081-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-014-0081-x

Keywords

Navigation