title: HLA-haploidentical nonmyeloablative stem cell transplantation: induction to tolerance without passing through mixed chimaerism.
abstract: There are few reports of unmanipulated HLA-haploidentical nonmyeloablative stem cell transplantation (NST) using only pharmacological acute graft-vs.-host disease (GVHD) prophylaxis. We present here a successful case of unmanipulated HLA-haploidentical NST for mediastinal large B cell lymphoma that was resistant to autologous peripheral blood stem cell transplantation (PBSCT). The conditioning regimen consisted of fludarabine, busulfan and rabbit anti-T-lymphocyte globulin (ATG) in addition to rituximab. GVHD prophylaxis was performed using tacrolimus and methylprednisolone 1 mg/kg. The patient had rapid engraftment, with 100% donor chimaerism in the lineages of both T cells and granulocytes on day +12, but developed no GVHD clinically. The patient is still in complete remission past day +1020, with no sign of chronic GVHD without receiving immunosuppressive agents. HLA-haploidentical NST may be performed without utilizing mixed chimaerism.
authors.affiliation: Department of Molecular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ikegame
authors.forename: M
authors.initials: M
authors.lastname: Kawakami
authors.forename: T
authors.initials: T
authors.lastname: Yamagami
authors.forename: H
authors.initials: H
authors.lastname: Maeda
authors.forename: K
authors.initials: K
authors.lastname: Onishi
authors.forename: Y
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: T
authors.initials: T
authors.lastname: Fujioka
authors.forename: T
authors.initials: T
authors.lastname: Masuda
authors.forename: I
authors.initials: I
authors.lastname: Kawase
authors.forename: H
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000517:prevention & control; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006650:Histocompatibility Testing; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D016393:Lymphoma, B-Cell / Q000628:therapy; D008479:Mediastinal Neoplasms / Q000628:therapy; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods