title: Haploidentical hematopoietic stem cell transplantation to adults  with hematologic malignancies: analysis of 66 cases at a single  Japanese center.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Toyama Prefectural Central Hospital, Nishinagae, Toyama, Japan. kurokawa@tch.pref.toyama.jp
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kurokawa
authors.forename: Ken
authors.initials: K
authors.lastname: Ishiyama
authors.forename: Jun
authors.initials: J
authors.lastname: Ozaki
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Noriko
authors.initials: N
authors.lastname: Iwaki
authors.forename: Chizuru
authors.initials: C
authors.lastname: Saito
authors.forename: Masahisa
authors.initials: M
authors.lastname: Arahata
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Kaya
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshida
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus
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