Intentional induction of mixed haematopoietic chimerism as platform for cellular therapy after HLA-matched allogeneic stem cell transplantation in childhood leukaemia patients.
Allogeneic peripheral blood stem cell CD34(+)-selected transplantation followed by donor lymphocyte infusion (DLI) to maximize graft-versus-leukaemia effect while avoiding graft-versus-host disease was investigated in 22 paediatric patients with acute myeloid leukaemia (n = 10) or acute lymphoblastic leukaemia (n = 12). Patients were grafted with a median (range) 6 x 10(6) (2-31 x 10(6))/kg CD34(+) cells and 1.1 x 10(4) (0.2-3.9 x 10(4)) CD3(+) cells. Seventy-five DLI were performed with no complications. Median time (range) to neutrophil and platelet engraftment was 13 (11-15) and 12 d (8-13) respectively. Probability of relapse and disease-free survival was 23 +/- 9% and 72 +/- 6% respectively (median follow-up of 15 months).
Division of Paediatric Hematology-Oncology, Haematopoietic Stem Cell transplantation Unit and Cellular Therapy, Hospital Niño Jesús, Madrid, Spain.
Antonio
A
Pérez
Marta
M
González-Vicent
Manuel
M
Ramirez
Julián
J
Sevilla
Luis
L
Madero
Miguel Angel
MA
Díaz
D000293:Adolescent; D018952:Antigens, CD34 / Q000276:immunology; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017252:CD3 Complex / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D020544:Graft vs Leukemia Effect; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D017710:Lymphocyte Transfusion / Q000379:methods*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D011336:Probability; D011446:Prospective Studies; D012008:Recurrence; D013234:Stem Cells / Q000276:immunology; D018183:Transplantation Chimera; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D018952:Antigens, CD34; D000970:Antineoplastic Agents; D017252:CD3 Complex; D014740:Vidarabine; C024352:fludarabine