title: Haploidentical, unmanipulated, G-CSF-primed bone marrow transplantation for patients with high-risk hematologic malignancies.
abstract: Eighty patients with high-risk hematologic malignancies underwent unmanipulated, G-CSF–primed BM transplantation from an haploidentical family donor. Patients were transplanted in first or second complete remission (CR, standard-risk: n =45) or in > second CR or active disease (high-risk: n =35). The same regimen for GVHD prophylaxis was used in all cases. The cumulative incidence (CI) of neutrophil engraftment was 93% 0.1%. The 100-day CIs for II-IV and III-IV grade of acute GVHD were 24% 0.2% and 5% 0.6%, respectively. The 2-year CI of extensive chronic GVHD was 6% 0.1%. The 1-year CI of treatment-related mortality was 36% 0.3%. After a median follow-up of 18 months, 36 of 80 (45%) patients are alive in CR. The 3-year probability of overall and disease-free survival for standard-risk and high-risk patients was 54% 8% and 33% 9% and 44% 8% and 30% 9%, respectively. In multivariate analysis, disease-free survival was significantly better for patients who had standard-risk disease and received transplantations after 2007. We conclude that unmanipulated, G-CSF–primed BM transplantation from haploidentical family donor provides very encouraging results in terms of engraftment rate, incidence of GVHD and survival and represents a feasible, valid alternative for patients with high-risk malignant hematologic diseases, lacking an HLA identical sibling and in need to be urgently transplanted.
  
  
  CONCLUSIONS
  Haploidentical, unmanipulated, G-CSF-primed bone marrow transplantation. Haploidentical hematopoietic stem cell transplantation for hematologic malignancies.
authors.affiliation: Department of Hematology, Bone Marrow Transplant Center, Spirito Santo Hospital, Pescara, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Bartolomeo
authors.forename: Stella
authors.initials: S
authors.lastname: Santarone
authors.forename: Gottardo
authors.initials: G
authors.lastname: De Angelis
authors.forename: Alessandra
authors.initials: A
authors.lastname: Picardi
authors.forename: Laura
authors.initials: L
authors.lastname: Cudillo
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cerretti
authors.forename: Gaspare
authors.initials: G
authors.lastname: Adorno
authors.forename: Stefano
authors.initials: S
authors.lastname: Angelini
authors.forename: Marco
authors.initials: M
authors.lastname: Andreani
authors.forename: Lidia
authors.initials: L
authors.lastname: De Felice
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Rapanotti
authors.forename: Loredana
authors.initials: L
authors.lastname: Sarmati
authors.forename: Pasqua
authors.initials: P
authors.lastname: Bavaro
authors.forename: Gabriele
authors.initials: G
authors.lastname: Papalinetti
authors.forename: Marta
authors.initials: M
authors.lastname: Di Nicola
authors.forename: Franco
authors.initials: F
authors.lastname: Papola
authors.forename: Mauro
authors.initials: M
authors.lastname: Montanari
authors.forename: Arnon
authors.initials: A
authors.lastname: Nagler
authors.forename: William
authors.initials: W
authors.lastname: Arcese
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000097:blood / Q000401:mortality / Q000628:therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019337:Hematologic Neoplasms / Q000097:blood / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014184:Transplantation, Homologous
chemical_list: D016179:Granulocyte Colony-Stimulating Factor