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Science China Life Sciences

, Volume 62, Issue 1, pp 104–111 | Cite as

Comparison of efficacy between HLA6/6- and HLA3/6-matched haploidentical hematopoietic stem cell transplant in T-cell-replete transplants between parents and children

  • Wenjing Yu
  • Yu Wang
  • Depei Wu
  • Qifa Liu
  • Lanping Xu
  • Xiaohui Zhang
  • Kaiyan Liu
  • Xiaojun HuangEmail author
Research Paper
  • 25 Downloads

Abstract

To compare the efficacy of HLA6/6-matched haploidentical hematopoietic stem cell transplant (haplo-HSCT) with that of HLA3/6-matched HSCT in T-cell-replete transplants, we recruited 27 consecutive recipients from multiple centers who received HLA6/6-matched haplo-HSCT from a parent or child donor between February 2010 and May 2016. A matched-pair analysis was designed. For each recipient from the study cohort, two recipients were randomly selected from the control cohort and matched (according to patient age, patient sex, disease type, disease status, donor age, donor sex, and recipient-donor relationship). No significant differences were found in hematopoietic recovery. The incidence of grade II–IV and III–IV acute graft versus host disease was similar (18.5% vs. 31.5%, P=0.216; 11.1% vs. 9.3%, P=0.792) in the HLA6/6 and HLA3/6 groups, respectively. The 3-year cumulative incidence of relapse was 14.8% and 17.0% (P=0.800). The 3-year cumulative incidence of nonrelapse mortality was 12.1% and 17.6% (P=0.751). The estimated 3-year disease-free survival was 73.1% and 65.5% (P=0.489). The estimated 3-year overall survival was 74.7% and 74.0% (P=0.946). The data suggested the efficacy and safety of the HLA6/6- and the HLA3/6-matched haplo-HSCT between parents and children are comparable. That HLA-mismatch disparity is not correlated with T-cell-replete haplo-HSCT outcome was substantiated.

Keywords

donor human leukocyte antigen hematopoietic stem cell transplantation 

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Notes

Acknowledgements

We thank all the faculty members that participated in these studies. This work was supported by National Natural Science Foundation of China (81400143, 81530046, 81621001) and National Key Research and Development Plan (2017YFA0104500).

References

  1. Anasetti, C., Beatty, P.G., Storb, R., Martin, P.J., Mori, M., Sanders, J.E., Donnall Thomas, E., and Hansen, J.A. (1990). Effect of HLA incompatibility on graft-versus-host disease, relapse, and survival after marrow transplantation for patients with leukemia or lymphoma. Human Immunol 29, 79–91.CrossRefGoogle Scholar
  2. Aversa, F., Tabilio, A., Velardi, A., Cunningham, I., Terenzi, A., Falzetti, F., Ruggeri, L., Barbabietola, G., Aristei, C., Latini, P., et al. (1998). Treatment of high-risk acute leukemia with T-cell-depleted stem cells from related donors with one fully mismatched HLA haplotype. N Engl J Med 339, 1186–1193.CrossRefGoogle Scholar
  3. Aversa, F., Terenzi, A., Tabilio, A., Falzetti, F., Carotti, A., Ballanti, S., Felicini, R., Falcinelli, F., Velardi, A., Ruggeri, L., et al. (2005). Full haplotype-mismatched hematopoietic stem-cell transplantation: a phase II study in patients with acute leukemia at high risk of relapse. J Clin Oncol 23, 3447–3454.CrossRefGoogle Scholar
  4. Beatty, P.G., Clift, R.A., Mickelson, E.M., Nisperos, B.B., Flournoy, N., Martin, P.J., Sanders, J.E., Stewart, P., Buckner, C.D., Storb, R., et al. (1985). Marrow transplantation from related donors other than HLAidentical siblings. N Engl J Med 313, 765–771.CrossRefGoogle Scholar
  5. Gray, R.J. (1988). A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Statist 16, 1141–1154.CrossRefGoogle Scholar
  6. Huang, X.J., and Chang, Y.J. (2011). Unmanipulated HLA-mismatched/haploidentical blood and marrow hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 17, 197–204.CrossRefGoogle Scholar
  7. Huang, X.J., Han, W., Xu, L.P., Chen, Y.H., Liu, D.H., Lu, J., Chen, H., Zhang, Y.C., Jiang, Q., Liu, K.Y., et al. (2004). A novel approach to human leukocyte antigen-mismatched transplantation in patients with malignant hematological disease. Chin Med J (Engl) 117, 1778–1785.Google Scholar
  8. Huang, X.J., Liu, D.H., Liu, K.Y., Xu, L.P., Chen, H., Han, W., Chen, Y.H., Wang, J.Z., Gao, Z.Y., Zhang, Y.C., et al. (2006). Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies. Bone Marrow Transplant 38, 291–297.CrossRefGoogle Scholar
  9. Huang, X.J., Liu, D.H., Liu, K.Y., Xu, L.P., Chen, H., Han, W., Chen, Y.H., Zhang, X.H., and Lu, D.P. (2009). Treatment of acute leukemia with unmanipulated HLA-mismatched/haploidentical blood and bone marrow transplantation. Biol Blood Marrow Transplant 15, 257–265.CrossRefGoogle Scholar
  10. Kasamon, Y.L., Luznik, L., Leffell, M.S., Kowalski, J., Tsai, H.L., Bolaños-Meade, J., Morris, L.E., Crilley, P.A., O'Donnell, P.V., Rossiter, N., et al. (2010). Nonmyeloablative HLA-haploidentical bone marrow transplantation with high-dose posttransplantation cyclophosphamide: effect of HLA disparity on outcome. Biol Blood Marrow Transplant 16, 482–489.CrossRefGoogle Scholar
  11. Luo, X.H., Chang, Y.J., Xu, L.P., Liu, D.H., Liu, K.Y., and Huang, X.J. (2009). The impact of graft composition on clinical outcomes in unmanipulated HLA-mismatched/haploidentical hematopoietic SCT. Bone Marrow Transplant 43, 29–36.CrossRefGoogle Scholar
  12. Morris, E.S., MacDonald, K.P.A., and Hill, G.R. (2006). Stem cell mobilization with G-CSF analogs: a rational approach to separate GVHD and GVL? Blood 107, 3430–3435.CrossRefGoogle Scholar
  13. Szydlo, R., Goldman, J.M., Klein, J.P., Gale, R.P., Ash, R.C., Bach, F.H., Bradley, B.A., Casper, J.T., Flomenberg, N., Gajewski, J.L., et al. (1997). Results of allogeneic bone marrow transplants for leukemia using donors other than HLA-identical siblings. J Clin Oncol 15, 1767–1777.CrossRefGoogle Scholar
  14. Tamaki, S., Ichinohe, T., Matsuo, K., Hamajima, N., Hirabayashi, N., Dohy, H., and Dohy, H. (2001). Superior survival of blood and marrow stem cell recipients given maternal grafts over recipients given paternal grafts. Bone Marrow Transplant 28, 375–380.CrossRefGoogle Scholar
  15. Wang, H.Y., Jin, H.S., Xu, Y.Y., Ding, Y., Sun, J.F., Wang, L.L., and Yu, L. (2012). Clinical analysis for 3 cases of HLA-matched between father and son and 1 case of post-hematopoietic stem cell transplant efficacy (in Chinese). Zhongguo Shi Yan Xue Ye Xue Za Zhi 20, 416–420.Google Scholar
  16. Wang, Y., Liu, D.H., Liu, K.Y., Xu, L.P., Zhang, X.H., Han, W., Chen, H., Chen, Y.H., Wang, F.R., Wang, J.Z., et al. (2013). Long-term follow-up of haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for the treatment of leukemia. Cancer 119, 978–985.CrossRefGoogle Scholar
  17. Wang, Y., Chang, Y.J., Xu, L.P., Liu, K.Y., Liu, D.H., Zhang, X.H., Chen, H., Han, W., Chen, Y.H., Wang, F.R., et al. (2014). Who is the best donor for a related HLA haplotype-mismatched transplant? Blood 124, 843–850.CrossRefGoogle Scholar
  18. Wang, Y., Wu, D.P., Liu, Q.F., Xu, L.P., Liu, K.Y., Zhang, X.H., Xu, Y., Huang, F., and Huang, X.J. (2018). Donor and recipient age, gender and ABO incompatibility regardless of donor source: validated criteria for donor selection for haematopoietic transplants. Leukemia 32, 492–498.CrossRefGoogle Scholar
  19. Yuan, F., Sun, Y.Y., Luo, Y., Liang, F., Liu, N., Jin, L., Liu, J.F., Liu, S.G., and Xi, Y.Z. (2007). Haplotype and linkage analysis of HLA-I classical genes in Chinese Han population (in Chinese). Zhongguo Shi Yan Xue Ye Xue Za Zhi 15, 1084–1089.Google Scholar
  20. Zhao, X., Gao, F., Zhang, X., Wang, Y., Xu, L., Liu, K., Zhao, X., Chang, Y., Wei, H., Chen, H., et al. (2016). Improved clinical outcomes of rhGCSF-mobilized blood and marrow haploidentical transplantation compared to propensity score-matched rhG-CSF-primed peripheral blood stem cell haploidentical transplantation: a multicenter study. Sci China Life Sci 59, 1139–1148.CrossRefGoogle Scholar

Copyright information

© Science China Press and Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Wenjing Yu
    • 1
  • Yu Wang
    • 1
  • Depei Wu
    • 3
  • Qifa Liu
    • 4
  • Lanping Xu
    • 1
  • Xiaohui Zhang
    • 1
  • Kaiyan Liu
    • 1
  • Xiaojun Huang
    • 1
    • 2
    Email author
  1. 1.Peking University People’s Hospital, Peking University Institute of HematologyBeijing Key Laboratory of Hematopoietic Stem Cell TransplantationBeijingChina
  2. 2.Peking-Tsinghua Center for Life SciencesBeijingChina
  3. 3.The First Affiliated Hospital of Soochow UniversitySuzhouChina
  4. 4.Nanfang HospitalSouthern Medical UniversityGuangzhouChina

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