title: The impact of T-cell depletion techniques on the outcome after haploidentical hematopoietic SCT.
abstract: Several T-cell depletion (TCD) techniques are used for haploidentical hematopoietic SCT (HSCT), but direct comparisons are rare. We therefore studied the effect of in vitro TCD with graft engineering (CD34 selection or CD3/CD19 depletion, 74%) or in vivo TCD using alemtuzumab (26%) on outcome, immune reconstitution and infections after haploidentical HSCT. We performed a retrospective multicenter analysis of 72 haploidentical HSCT in Switzerland. Sixty-seven patients (93%) had neutrophil engraftment. The 1-year OS, TRM and relapse incidence were 48 (36-60)%, 20 (11-33)% and 42 (31-57)%, respectively, without differences among the TCD groups. In vivo TCD caused more profound lymphocyte suppression early after HSCT, whereas immune recovery beyond the second month was comparable between the two groups. Despite anti-infective prophylaxis, most patients experienced post-transplant infectious complications (94%). Patients with in vivo TCD had a higher incidence of CMV reactivations (54% vs 28%, P=0.015), but this did not result in a higher TRM. In conclusion, TCD by graft engineering or alemtuzumab are equally effective for haploidentical HSCT.
authors.affiliation: Division of Hematology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Marek
authors.affiliation: Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Stern
authors.affiliation: Service of Hematology, Department of Internal Medicine, University Hospital Geneva, Geneva, Switzerland.
authors.forename: Y
authors.initials: Y
authors.lastname: Chalandon
authors.affiliation: Hematology and Oncology Unit, Department of Pediatrics, University Hospital Geneva, Geneva, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Ansari
authors.affiliation: Hematology and Oncology Unit, Department of Pediatrics, University Hospital Geneva, Geneva, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Ozsahin
authors.affiliation: Division of Immunology/BMT, Children's Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Güngör
authors.affiliation: Division of Hematology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Gerber
authors.affiliation: Division of Oncology/Hematology, University Children's Hospital Basel, Basel, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Kühne
authors.affiliation: 1] Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland [2] Service of Hematology, Department of Internal Medicine, University Hospital Geneva, Geneva, Switzerland.
authors.forename: J R
authors.initials: JR
authors.lastname: Passweg
authors.affiliation: Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Gratwohl
authors.affiliation: Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Tichelli
authors.affiliation: Division of Immunology/BMT, Children's Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: R
authors.initials: R
authors.lastname: Seger
authors.affiliation: Division of Hematology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: U
authors.initials: U
authors.lastname: Schanz
authors.affiliation: Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Halter
authors.affiliation: Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Stussi
mesh_terms: D000293:Adolescent; D000327:Adsorption; D000328:Adult; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D018941:Antigens, CD19 / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017252:CD3 Complex / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease; D019337:Hematologic Neoplasms / Q000628:therapy*; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D012008:Recurrence; D012189:Retrospective Studies; D013557:Switzerland; D013601:T-Lymphocytes / Q000276:immunology*; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018941:Antigens, CD19; D018952:Antigens, CD34; D000970:Antineoplastic Agents; D017252:CD3 Complex; D000074323:Alemtuzumab
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