Abstract
Human leukocyte antigen (HLA) mismatched unrelated donor transplantation is associated with an increased risk of graft-versus-host disease, graft failure, and infection, which increases post-transplant morbidity and mortality. In this single-center retrospective study, outcomes were evaluated in 30 consecutive children who underwent bone marrow transplantation (BMT) from HLA 1 allele-mismatched (HLA 7/8-matched) unrelated donors with rabbit anti-thymocyte globulin (rATG) as graft-versus-host disease (GVHD) prophylaxis. The 3-year overall survival (OS), event-free survival (EFS), and GVHD-relapse-free survival rates were 91.7% (95% CI 70.5%–91.9%), 88.3% (95% CI 67.5%–96.1%), and 73.9% (95% CI 52.4%–86.8%), respectively. Grade II–IV and III–IV acute GVHD occurred in 10 (33%) and 2 (7.0%) patients, respectively. The 3-year cumulative incidence of chronic GVHD was 7.8%. No fatal viral infections occurred. The study results show the feasibility of HLA 7/8-matched unrelated BMT with ATG to achieve favorable outcomes and acceptable GVHD, especially for patients who lack a fully matched donor.
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Data availability
The data that support the findings of this study are available on request from the corresponding authors, HM or YT. The data are not publicly available because they contain information that could compromise the privacy of the research participants.
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Acknowledgements
The authors would like to thank all clinicians and families who made this study possible. The authors thank Ms. Yoshie Miura and Ms. Hiroko Ono for their valuable assistance.
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MH and HM gathered clinical information, designed and conducted the research, analyzed the collected data, and wrote the paper; KS, AN, TY, MI, AY, MW, SM, KN, SK, NK, RT, EN, and NN gathered clinical information; YT and YI performed monitoring studies; KS supervised the research; and YT directed the research and wrote the paper.
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Hamada, M., Muramatsu, H., Torii, Y. et al. Human leukocyte antigen 7/8-matched unrelated bone marrow transplantation using anti-thymocyte globulin in children. Int J Hematol 118, 125–130 (2023). https://doi.org/10.1007/s12185-023-03571-5
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DOI: https://doi.org/10.1007/s12185-023-03571-5