Haploidentical hematopoietic stem cell transplantation to adults  with hematologic malignancies: analysis of 66 cases at a single  Japanese center.
Sixty-six adult patients with hematologic malignancies underwent haploidentical hematopoietic stem cell transplantation (haplo-HSCT) without T cell depletion. The patients were preconditioned with a reduced intensity regimen, and tacrolimus was used for graft-versus-host disease (GVHD) prophylaxis. Successful engraftment occurred in 60 patients (90.1%) and graft rejection in only 4 patients (6.1%). Among the 60 engrafted patients, only 5 developed severe (grade III or IV) acute GVHD. Twenty patients, including 19 relapse-free patients were alive at a median follow-up of 48 months (range 6-77 months). The overall survival (OS) at 6 years was 29.3%. The OS of 45 patients < 60 years of age was 43.6%, which was superior to that of 21 patients who were 60 years of age and older (9.5%) (P < 0.01). The OS of 11 patients from human leukocyte antigen (HLA) 1 locus-mismatched donors (63.6%) was higher than that of 28 patients from HLA 3 loci-mismatched donors (12.5%) (P < 0.01). Organ injury and infection were the main causes of mortality. Notably, immunosuppressive therapy could be successfully stopped in 9 patients transplanted from HLA 2 or 3 loci-mismatched donors with a median duration of 45 months (range 5-71 months). These data suggest that haplo-HSCT is a promising treatment for patients who need urgent allogeneic transplantation but lack HLA-identical family donors.
Kurokawa
Toshiro
T
Department of Internal Medicine, Toyama Prefectural Central Hospital, Nishinagae, Toyama, Japan. kurokawa@tch.pref.toyama.jp
Ishiyama
Ken
K
Ozaki
Jun
J
Yamashita
Yumiko
Y
Iwaki
Noriko
N
Saito
Chizuru
C
Arahata
Masahisa
M
Kaya
Hiroyasu
H
Yoshida
Takashi
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D003586:Cytomegalovirus Infections / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000188:drug therapy / Q000401:mortality; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000401:mortality; D006239:Haplotypes; D019337:Hematologic Neoplasms / Q000235:genetics / Q000401:mortality / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan / Q000453:epidemiology; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000166:cytology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D016559:Tacrolimus / Q000627:therapeutic use; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D055815:Young Adult
D007166:Immunosuppressive Agents; D016559:Tacrolimus
Bone Marrow Transplant. 2007 Jun;39(11):705-9
17401392
Bone Marrow Transplant. 1995 Feb;15(2):247-53
7773214
Blood. 2007 Jul 1;110(1):433-40
17371948
Leukemia. 2008 Jan;22(1):31-41
17805330
N Engl J Med. 2004 Nov 25;351(22):2265-75
15564543
Blood. 2005 Oct 15;106(8):2912-9
15994282
Blood. 1999 Jun 1;93(11):3983-93
10339508
Bone Marrow Transplant. 2004 Jun;33(11):1143-50
15077133
Transplantation. 1974 Oct;18(4):295-304
4153799
Transplantation. 2005 Jun 15;79(11):1507-15
15940039
Br J Haematol. 1994 Jan;86(1):130-7
8011521
Blood. 2006 Apr 15;107(8):3065-73
16380454
Exp Hematol. 2008 Jan;36(1):1-8
17920757
Eur J Haematol. 2005 Oct;75(4):352-4
16146543
Blood. 2001 Jun 1;97(11):3676-7
11392331
Bone Marrow Transplant. 1999 Feb;23(3):251-8
10084256
Am J Med. 1980 Aug;69(2):204-17
6996481
Blood. 2004 Dec 1;104(12):3821-8
15280193
Biol Blood Marrow Transplant. 2001;7(9):473-85
11669214
Biol Blood Marrow Transplant. 2006 Oct;12(10):1073-84
17084371
N Engl J Med. 1994 Apr 28;330(17):1185-91
8093146
Blood. 2002 Mar 1;99(5):1572-7
11861270
Biol Blood Marrow Transplant. 2007 Jan;13(1):100-6
17222758
Blood. 2005 Feb 15;105(4):1408-16
15486071
Bone Marrow Transplant. 2006 Aug;38(4):291-7
16883312
Br J Haematol. 2001 Dec;115(3):630-41
11736948
Blood. 1999 Jan 15;93(2):467-80
9885208
Blood. 2004 Dec 1;104(12):3813-20
15280199
Blood. 2006 Oct 15;108(8):2874-80
16804113
Lancet. 2007 Jun 9;369(9577):1947-54
17560447
N Engl J Med. 2000 Jun 22;342(25):1846-54
10861319
N Engl J Med. 2004 Nov 25;351(22):2276-85
15564544