title: Peripheral blood hematopoietic stem cells for transplantation of hematological diseases from related, haploidentical donors after reduced-intensity conditioning.
abstract: In a multicenter collaboration, we carried out T cell-replete, peripheral blood stem cell (PBSC) transplantations from related, HLA-haploidentical donors with reduced-intensity conditioning (RIC) and post-transplantation cyclophosphamide (Cy) as graft-versus-host disease (GVHD) prophylaxis in 55 patients with high-risk hematologic disorders. Patients received 2 doses of Cy 50 mg/kg i.v. on days 3 and 4 after infusion of PBSC (mean, 6.4 × 10(6)/kg CD34(+) cells; mean, 2.0 × 10(8)/kg CD3(+) cells). The median times to neutrophil (500/μL) and platelet (>20,000/μL) recovery were 17 and 21 days respectively. All but 2 of the patients achieved full engraftment. The 1-year cumulative incidences of grade II and grade III acute GVHD were 53% and 8%, respectively. There were no cases of grade IV GVHD. The 2-year cumulative incidence of chronic GHVD was 18%. With a median follow-up of 509 days, overall survival and event-free survival at 2 years were 48% and 51%, respectively. The 2-year cumulative incidences of nonrelapse mortality and relapse were 23% and 28%, respectively. Our results suggest that PBSC can be substituted safely and effectively for bone marrow as the graft source for haploidentical transplantation after RIC.
authors.affiliation: Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Kavita
authors.initials: K
authors.lastname: Raj
authors.affiliation: Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom; King's College London, United Kingdom.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagliuca
authors.affiliation: Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bradstock
authors.affiliation: Department of Haematological Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Victor
authors.initials: V
authors.lastname: Noriega
authors.affiliation: Department of Haematological Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Victoria
authors.initials: V
authors.lastname: Potter
authors.affiliation: Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Streetly
authors.affiliation: Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Donal
authors.initials: D
authors.lastname: McLornan
authors.affiliation: Guy's and St Thomas' NHS Hospitals Foundation Trusts, London, United Kingdom; Department of Haematological Medicine, King's College Hospital, London, United Kingdom.
authors.forename: Majid
authors.initials: M
authors.lastname: Kazmi
authors.affiliation: Department of Haematological Medicine, King's College Hospital, London, United Kingdom; King's College London, United Kingdom.
authors.forename: Judith
authors.initials: J
authors.lastname: Marsh
authors.affiliation: Westmead Hospital, Sydney, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Kwan
authors.affiliation: Westmead Hospital, Sydney, NSW, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Huang
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Lisa
authors.initials: L
authors.lastname: Getzendaner
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington, Seattle.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lee
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Guthrie
authors.affiliation: Department of Haematological Medicine, King's College Hospital, London, United Kingdom; King's College London, United Kingdom.
authors.forename: Ghulam J
authors.initials: GJ
authors.lastname: Mufti
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington, Seattle. Electronic address: podonnel@fhcrc.org.
authors.forename: Paul
authors.initials: P
authors.lastname: O'Donnell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006238:Haploidy; D006402:Hematologic Diseases / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D014019:Tissue Donors; D018183:Transplantation Chimera; D019172:Transplantation Conditioning / Q000379:methods*; D055815:Young Adult
keywords: Haploidentical; Peripheral blood stem cell; Stem cell transplantation