Synapse - T cell-depleted unrelated donor stem cell transplantation provides favorable disease-free survival for adults with hematologic malignancies

T cell-depleted unrelated donor stem cell transplantation provides favorable disease-free survival for adults with hematologic malignancies Journal Article

Authors:	Jakubowski, A. A.; Small, T. N.; Kernan, N. A.; Castro-Malaspina, H.; Collins, N.; Koehne, G.; Hsu, K. C.; Perales, M. A.; Papanicolaou, G.; van den Brink, M. R. M.; O'Reilly, R. J.; Young, J. W.; Papadopoulos, E. B.
Article Title:	T cell-depleted unrelated donor stem cell transplantation provides favorable disease-free survival for adults with hematologic malignancies
Abstract:	We report a prospective phase 11 clinical trial in 35 adult patients (median age 40.5 years) with hematologic malignancies who received T cell depleted, hematopoietic stem cell transplants from HLA-compatible, unrelated donors. The cytoreductive regimen consisted of hyperfractionated total-body irradiation, thiotepa, and fludarabine. The preferred graft source was granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood stem cells (PBSC). PBSC were CD34(+) selected, followed by sheep erythrocyte rosetting to deplete residual T cells. Anti-thymocyte globulin provided graft rejection prophylaxis. No additional graft-versus-host disease (GVHD) prophylaxis was planned. Estimated disease-free survival at 4 years is 56.8% for the entire group and 75% in patients with standard-risk disease. The cumulative incidence of relapse is 6%. Acute GVHD grade II-III developed in 9% and chronic GVHD in 29% of patients. Fatal infections occurred in 5 of 35 (14%) patients. There was 1 late graft failure. This study demonstrates durable engraftment with a low overall incidence of GVHD. Its curative potential is reflected in the remarkably low relapse rate at 4 years. Bid Blood Marrow Transplant 17: 1335-1342 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
Keywords:	leukemia; graft failure; hematologic malignancies; t cell depletion; versus-host-disease; bone-marrow-transplantation; acute myeloid-leukemia; chronic myelogenous; unrelated donor; hematopoietic stem cell transplant; ii-iii trial; antithymocyte globulin; lymphocyte infusion; leukocyte infusions; immune recovery
Journal Title:	Biology of Blood and Marrow Transplantation
Volume:	17
Issue:	9
ISSN:	1083-8791
Publisher:	Elsevier Inc.
Date Published:	2011-09-01
Start Page:	1335
End Page:	1342
Language:	English
DOI:	10.1016/j.bbmt.2011.01.005
ACCESSION:	WOS:000294594900009
PROVIDER:	wos
PMCID:	PMC3094599
PUBMED:	21232623
Notes:	--- - Article - "Source: Wos"