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International Journal of Hematology

, Volume 85, Issue 3, pp 246–255 | Cite as

Outcome of Non-T-Cell-Depleted HLA-Haploidentical Hematopoietic Stem Cell Transplantation from Family Donors in Children and Adolescents

  • Takao Yoshihara
  • Keiko Okada
  • Michihiro Kobayashi
  • Atsushi Kikuta
  • Koji Kato
  • Naoto Adachi
  • Akira Kikuchi
  • Hiroyuki Ishida
  • Yasuzou Hirota
  • Hiroshi Kuroda
  • Yoshihisa Nagatoshi
  • Takeshi Inukai
  • Kazutoshi Koike
  • Hisato Kigasawa
  • Hiroshi Yagasaki
  • Kiriko Tokuda
  • Tomoko Kishimoto
  • Takahide Nakano
  • Naoto Fujita
  • Hiroaki Goto
  • Yozo Nakazawa
  • Hirokazu Kanegane
  • Akinobu Matsuzaki
  • Yuko Osugi
  • Daiichiro Hasegawa
  • Nobuhiko Uoshima
  • Kazuhiro Nakamura
  • Masahiro Tsuchida
  • Ryuhei Tanaka
  • Arata Watanabe
  • Hiromasa Yabe
Article

Abstract

Non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation (SCT) from family members has been reported, but its effectiveness and safety are not fully known. In this study, we examined the outcomes of 83 children and adolescents with nonmalignant (n = 11) or malignant (n = 72) disorders who underwent SCT mismatched at 2 or 3 HLA loci, either from the mother (n = 56), a noninherited maternal antigen (NIMA)-mismatched sibling (n = 14), or the father/a noninherited paternal antigen (NIPA)-mismatched sibling (n = 13). Engraftment was satisfactory. Severe (grade III-IV) acute graft-versus-host disease (GVHD) was noted only in malignant disease, with an incidence of 21 of 64 evaluable patients. GVHD prophylaxis with a combination of tacrolimus and methotrexate was significantly associated with a lower risk of severe acute GVHD, compared with other types of prophylaxis(P = .04). Nine of 11 patients with nonmalignant disease and 29 of 72 patients with malignant disease were alive at a median follow-up of 26 months (range, 4-57 months). Outcomes were not significantly different among the 3 donor groups (mother versus NIMA-mismatched sibling versus father/NIPA-mismatched sibling) for the malignancy disorders. Our results indicate that non-T-cell-depleted HLA-haploidentical SCT may be feasible, with appropriate GVHD prophylaxis, for young recipients who lack immediate access to a conventional stem cell source.

Key words

Hematopoietic stem cell transplantation HLA-haploidentical donor Noninherited maternal antigen (NIMA) Long-term fetomaternal microchimerism Childhood 

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Copyright information

© The Japanese Society of Hematology 2007

Authors and Affiliations

  • Takao Yoshihara
    • 1
  • Keiko Okada
    • 2
  • Michihiro Kobayashi
    • 3
  • Atsushi Kikuta
    • 4
  • Koji Kato
    • 5
  • Naoto Adachi
    • 6
  • Akira Kikuchi
    • 7
  • Hiroyuki Ishida
    • 1
  • Yasuzou Hirota
    • 8
  • Hiroshi Kuroda
    • 9
  • Yoshihisa Nagatoshi
    • 10
  • Takeshi Inukai
    • 11
  • Kazutoshi Koike
    • 12
  • Hisato Kigasawa
    • 13
  • Hiroshi Yagasaki
    • 14
  • Kiriko Tokuda
    • 15
  • Tomoko Kishimoto
    • 16
  • Takahide Nakano
    • 17
  • Naoto Fujita
    • 18
  • Hiroaki Goto
    • 19
  • Yozo Nakazawa
    • 20
  • Hirokazu Kanegane
    • 21
  • Akinobu Matsuzaki
    • 22
  • Yuko Osugi
    • 23
  • Daiichiro Hasegawa
    • 24
  • Nobuhiko Uoshima
    • 25
  • Kazuhiro Nakamura
    • 26
  • Masahiro Tsuchida
    • 12
  • Ryuhei Tanaka
    • 27
  • Arata Watanabe
    • 28
  • Hiromasa Yabe
    • 29
  1. 1.Department of PediatricsMatsushita Memorial HospitalMoriguchiJapan
  2. 2.Osaka University Graduate School of MedicineOsakaJapan
  3. 3.Graduate School of MedicineKyoto UniversityKyotoJapan
  4. 4.Fukushima Medical UniversityFukushimaJapan
  5. 5.Japanese Red Cross Nagoya First HospitalNagoyaJapan
  6. 6.Kumamoto University Graduate School of Medical SciencesKumamotoJapan
  7. 7.Saitama Children’s Medical CenterSaitamaJapan
  8. 8.Show a University Fujigaoka Hospital, YokohamaJapan
  9. 9.Kyoto City HospitalKyotoJapan
  10. 10.National Kyushu Cancer Center, FukuokaJapan
  11. 11.Faculty of MedicineUniversity of YamanashiNakakomaJapan
  12. 12.Ibaraki Children’s HospitalMitoJapan
  13. 13.Kanagawa Children’s Medical CenterYokohamaJapan
  14. 14.Graduate School of MedicineNagoya UniversityNagoyaJapan
  15. 15.Ehime University School of MedicineTouonJapan
  16. 16.Nara Medical UniversityKashiharaJapan
  17. 17.Kansai Medical UniversityMoriguchiJapan
  18. 18.Hiroshima Red-Cross and Atomic-Bomb Survivors HospitalHiroshimaJapan
  19. 19.Yokohama City University School of MedicineYokohamaJapan
  20. 20.Shinshu University School of MedicineMatsumotoJapan
  21. 21.Faculty of MedicineUniversity of ToyamaToyamaJapan
  22. 22.Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  23. 23.Osaka City General HospitalOsakaJapan
  24. 24.Hyogo Prefectural Kobe Children’s HospitalKobeJapan
  25. 25.Department of HematologyMatsushita Memorial HospitalMoriguchiJapan
  26. 26.Hiroshima University School of MedicineHiroshimaJapan
  27. 27.Saitama Medical School HospitalIrumaJapan
  28. 28.Nakadori General HospitalAkitaJapan
  29. 29.Tokai University School of MedicineIseharaJapan

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