Successful treatment of refractory T-cell acute lymphoblastic leukemia by unmanipulated stem cell transplantation from an HLA 3-loci mismatched (haploidentical) sibling.
We describe a patient with refractory T-cell acute lymphoblastic leukemia who successfully underwent unmanipulated stem cell transplantation from an HLA 3-loci mismatched (haploidentical) sibling. In order to avoid severe graft-versus-host disease (GVHD), we used intensified GVHD prophylaxis consisting of tacrolimus, a short course of methotrexate, methylprednisolone, and mycophenolate mofetil. Hematopoietic reconstitution was rapid, with neutrophil count >5 x 10(8)/l on day +16, and platelet count >2 x 10(10)/l on day +25. There was no evidence of clinical acute GVHD. Bacterial, fungal, and viral infections were well controlled with antibiotics. The patient is still in complete remission past day +400. We suggest that unmanipulated HLA-mismatched transplantation with intensified GVHD prophylaxis is an alternative option for patients who do not have an HLA-identical donor.
Ikegame
K
K
Department of Molecular Medicine, Osaka University Graduate School of Medicine, Japan.
Tanji
Y
Y
Kitai
N
N
Tamaki
H
H
Kawakami
M
M
Fujioka
T
T
Oka
Y
Y
Maruya
E
E
Saji
H
H
Sugiyama
H
H
Ogawa
H
H
D000328:Adult; D006086:Graft vs Host Disease / Q000517:prevention & control; D006238:Haploidy; D018380:Hematopoietic Stem Cell Transplantation; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015458:Leukemia, T-Cell / Q000628:therapy*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D035781:Siblings; D014019:Tissue Donors
D007166:Immunosuppressive Agents