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Haploidentical hematopoietic stem cell transplantation to adults with hematologic malignancies: analysis of 66 cases at a single Japanese center

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Abstract

Sixty-six adult patients with hematologic malignancies underwent haploidentical hematopoietic stem cell transplantation (haplo-HSCT) without T cell depletion. The patients were preconditioned with a reduced intensity regimen, and tacrolimus was used for graft-versus-host disease (GVHD) prophylaxis. Successful engraftment occurred in 60 patients (90.1%) and graft rejection in only 4 patients (6.1%). Among the 60 engrafted patients, only 5 developed severe (grade III or IV) acute GVHD. Twenty patients, including 19 relapse-free patients were alive at a median follow-up of 48 months (range 6–77 months). The overall survival (OS) at 6 years was 29.3%. The OS of 45 patients <60 years of age was 43.6%, which was superior to that of 21 patients who were 60 years of age and older (9.5%) (P < 0.01). The OS of 11 patients from human leukocyte antigen (HLA) 1 locus-mismatched donors (63.6%) was higher than that of 28 patients from HLA 3 loci-mismatched donors (12.5%) (P < 0.01). Organ injury and infection were the main causes of mortality. Notably, immunosuppressive therapy could be successfully stopped in 9 patients transplanted from HLA 2 or 3 loci-mismatched donors with a median duration of 45 months (range 5–71 months). These data suggest that haplo-HSCT is a promising treatment for patients who need urgent allogeneic transplantation but lack HLA-identical family donors.

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Authors and Affiliations

  1. Department of Internal Medicine, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama, 930-8550, Japan

    Toshiro Kurokawa, Noriko Iwaki, Chizuru Saito, Hiroyasu Kaya & Takashi Yoshida

  2. Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

    Ken Ishiyama

  3. NTT West Japan Kanazawa Hospital, Kanazawa, Japan

    Jun Ozaki & Yumiko Yamashita

  4. Nanto Municipal Hospital, Nanto, Japan

    Masahisa Arahata

Authors
  1. Toshiro Kurokawa
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  2. Ken Ishiyama
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  3. Jun Ozaki
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  4. Yumiko Yamashita
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  5. Noriko Iwaki
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  6. Chizuru Saito
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  7. Masahisa Arahata
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  8. Hiroyasu Kaya
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  9. Takashi Yoshida
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Correspondence to Toshiro Kurokawa.

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Kurokawa, T., Ishiyama, K., Ozaki, J. et al. Haploidentical hematopoietic stem cell transplantation to adults with hematologic malignancies: analysis of 66 cases at a single Japanese center. Int J Hematol 91, 661–669 (2010). https://doi.org/10.1007/s12185-010-0561-5

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  • DOI: https://doi.org/10.1007/s12185-010-0561-5

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