CD34+ selected cells in mismatched stem cell transplantation: a single centre experience of haploidentical peripheral blood stem cell transplantation.
Over the past 3 years we have performed 10 haploidentical peripheral blood stem cell transplants in patients with incurable haematological malignancies and no prospect of a matched unrelated donor within an adequate time period. Conditioning consisted of ATG, TBI, thiotepa, cyclophosphamide and additional radioimmunotherapy in five patients. All patients received G-CSF mobilized peripheral blood stem cell grafts. GVHD prophylaxis consisted of T cell depletion by CD34+ selection; no post-transplant immunosuppression was given in nine patients. Stable engraftment was achieved in nine patients; one case of acute graft rejection was observed. Seven patients developed grade I acute GVHD, and six patients have developed chronic GVHD. Infections were the most significant clinical problem post transplant. Two patients have suffered a relapse of their disease and two further patients have died of transplant-related complications. After a median follow-up of 13 months (range 5-37 months) six patients are surviving in remission. We conclude that haploidentical PBSCT is a reasonable alternative to a MUD transplant.
Bunjes
D
D
Department of Internal Medicine III, Ulm University Hospital, Germany.
Duncker
C
C
Wiesneth
M
M
Stefanic
M
M
Dohr
D
D
Harsdorf
S
S
Karakas
T
T
Reske
S N
SN
Bergmann
L
L
D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism*; D003586:Cytomegalovirus Infections / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000276:immunology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence
D018952:Antigens, CD34