Partially matched transplants with allogeneic CD34+ blood cells.
Allogeneic CD34(+) selected cell transplantation from a partially matched donor is feasible for the treatment of hematopoietic malignancies. Severe graft-versus-host disease (GvHD) can be prevented by this approach, and a lengthy search for an unrelated donor can be avoided. However, long-term engraftment is still a challenge, and may require intensified conditioning regimens with severe toxicities to sustain engraftment. Furthermore, unacceptable effects such as relapse and life-threatening viral infections might be more frequent after such transplants compared with non-T-cell-depleted transplants from an HLA-identical donor. Strict indications should be considered for this treatment based on a risk/benefit assessment for very high-risk patients. The early application of periodic donor leukocyte infusion (DLI) may be useful for preventing both late graft rejection and serious viral infections.
Watanabe
T
T
Department of Pediatrics, University of Tokushima School of Medicine, Kuramoto-cho 3-18-15, Tokushima 770-8503, Japan. twatanab@clin.med.tokushima.u.ac.jp
Mineishi
S
S
Kawano
Y
Y
Takaue
Y
Y
D000293:Adolescent; D018952:Antigens, CD34 / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006082:Graft Enhancement, Immunologic; D006084:Graft Rejection / Q000517:prevention & control; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology; D006680:HLA Antigens / Q000276:immunology*; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000628:therapy; D019650:Hematopoietic Stem Cell Mobilization; D006648:Histocompatibility; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D017708:Leukocyte Transfusion; D008212:Lymphocyte Depletion; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D012306:Risk; D016511:Severe Combined Immunodeficiency / Q000628:therapy; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000276:immunology*; D016896:Treatment Outcome
D018952:Antigens, CD34; D006680:HLA Antigens; D016179:Granulocyte Colony-Stimulating Factor