HLA-DR-matched parental donors for allogeneic hematopoietic stem cell transplantation in patients with high-risk acute leukemia.
The immunomodulating effect of human leukocyte antigen (HLA)-DR and the central role of CD4 T cells in alloimmunity provide clues suggesting that HLA-DR-matched, partially mismatched related donors could be feasible alternative donors of allogeneic hematopoietic stem cells for transplantations (allo-HSCT). We describe our experience with allo-HSCT in eight patients with high-risk acute leukemia; donors included one of each of the parents. Among the eight patients, seven were identical HLA-DR matches with the donors. The stem cells were not manipulated in vitro. Graft-versus-host disease (GVHD) prophylaxis consisted of antithymocyte globulin, cyclosporine, and methotrexate. All patients had successful trilineage engraftment. Only one patient had grade 2-4 acute GVHD. Two patients died before day +100 due to complications. At the end of follow-up, four patients had survived for 18-48 months and three are alive and without relapse. Our results suggest that HLA-DR fully-matched parents are feasible alternative donors for allo-HSCT in patients with high-risk acute leukemia under an intensive conditioning regimen.
Wu
Shang-Ju
SJ
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Yao
Ming
M
Tang
Jih-Luh
JL
Ko
Bo-Sheng
BS
Tien
Hwei-Fang
HF
Chen
Yao-Chang
YC
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006684:HLA-DR Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D019520:Living Donors; D008297:Male; D010290:Parents; D014184:Transplantation, Homologous
D006684:HLA-DR Antigens