Feasibility and outcome of reduced-intensity conditioning in haploidentical transplantation.
Allogeneic stem cell transplantation is for a number of patients with malignant and nonmalignant diseases the only curative approach. For those patients who do not have an HLA-identical-related or -unrelated stem cell donor, a related three-loci mismatch haploidentical stem cell transplantation with T cell-depleted stem cells is a viable option. T cell depletion either by CD34(+) positive selection or by CD3-negative depletion strategies is available and has been investigated. We have shown that reduced-intensity conditioning haploidentical transplantation using mobilized peripheral stem cells negatively depleted from T and B lymphocytes is associated with a rapid immune reconstitution, a low transplant-related mortality rate, and a favorable outcome in patients in remission at the time of transplant. For chemorefractory patients, additional posttransplant cellular and humoral immunotherapeutic strategies are needed for prevention of relapse after transplantation.
Handgretinger
Rupert
R
Children's University Hospital, University of Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany. Rupert.Handgretinger@med.uni-tuebingen.de
Chen
Xiaohua
X
Pfeiffer
Matthias
M
Mueller
Ingo
I
Feuchtinger
Tobias
T
Hale
Gregory A
GA
Lang
Peter
P
D018952:Antigens, CD34 / Q000096:biosynthesis; D001402:B-Lymphocytes / Q000378:metabolism; D017252:CD3 Complex / Q000096:biosynthesis; D005240:Feasibility Studies; D006085:Graft Survival; D006086:Graft vs Host Disease; D006680:HLA Antigens / Q000737:chemistry*; D006650:Histocompatibility Testing / Q000379:methods; D006801:Humans; D007107:Immune System; D012008:Recurrence; D033581:Stem Cell Transplantation / Q000379:methods*; D013601:T-Lymphocytes / Q000378:metabolism; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000379:methods*
D018952:Antigens, CD34; D017252:CD3 Complex; D006680:HLA Antigens