T cell depletion as an alternative approach for patients 55 years or older undergoing allogeneic stem cell transplantation as curative therapy for hematologic malignancies Journal Article
| Authors: | Jakubowski, A. A.; Petrlik, E.; Maloy, M.; Hilden, P.; Papadopoulos, E.; Young, J. W.; Boulad, F.; Castro-Malaspina, H.; Tamari, R.; Dahi, P. B.; Goldberg, J.; Koehne, G.; Perales, M. A.; Sauter, C. S.; O'Reilly, R. J.; Giralt, S. |
| Article Title: | T cell depletion as an alternative approach for patients 55 years or older undergoing allogeneic stem cell transplantation as curative therapy for hematologic malignancies |
| Abstract: | T cell–depleted (TCD) allogeneic hematopoietic stem cell transplantation (HSCT) is curative treatment for hematologic malignancies in adults, shown to reduce graft-versus-host disease (GVHD) without increased relapse. We retrospectively reviewed a single-center, 11-year experience of 214 patients aged ≥ 55 years to determine tolerability and efficacy in the older adult. Most patients (70%) had myeloid diseases, and most acute leukemias were in remission. Median age was 61 years, with related and unrelated donors ≥8/10 HLA matched. Hematopoietic cell transplantation–specific comorbidity index scores were intermediate and high for 84%. Conditioning regimens were all myeloablative. Grafts were peripheral blood stem cells (97%) containing CD3 dose ≤103-4/kg body weight, without pharmacologic GVHD prophylaxis. With median follow-up of 70 months among survivors, Kaplan-Meier estimates of overall and relapse-free survival were 44% and 41%, respectively (4 years). Cumulative incidence of nonrelapse mortality at day +100 was only 10%. Incidence of GVHD for acute (grades II to IV) was 9% at day +100 and for chronic was 7% at 2 and 4 years (8 extensive, 1 overlap). Median Karnofsky performance status for patients > 2 years post-transplant was 90%. As 1 of the largest reports for patients ≥2 aged ≥55 years receiving TCD HSCTs, it demonstrates curative therapy with minimal GVHD, similar to that observed in a younger population. © 2017 The American Society for Blood and Marrow Transplantation |
| Keywords: | transplantation; older adults; ex vivo tcd |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 23 |
| Issue: | 10 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2017-10-01 |
| Start Page: | 1685 |
| End Page: | 1694 |
| Language: | English |
| DOI: | 10.1016/j.bbmt.2017.06.024 |
| PROVIDER: | scopus |
| PUBMED: | 28734876 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2017 -- Source: Scopus |
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