title: Refinement of treatment strategies in ex vivo T-cell-depleted haploidentical SCT for pediatric patients.
abstract: We evaluated the feasibility of T-cell-depleted haploidentical hematopoietic SCT (HHCT) in pediatric patients. Between July 2008 and January 2013, 28 patients underwent ex vivo T-cell-depleted HHCT; 9 had hematologic malignancy, 18 had nonmalignant hematologic disease, and 1 had refractory neuroblastoma. Twenty-six patients achieved neutrophil engraftment at a median of 11 days (range, 9-15 days). Two patients failed to achieve primary engraftment and five experienced graft rejection after primary engraftment. These seven patients achieved stable engraftment after a second HHCT. The cumulative incidences (CIs) of⩾grade II and⩾grade III acute GVHD were 33.3% and 14.3%, respectively, and the 1-year CI of extensive chronic GVHD was 11.1%. Four patients died of non-relapse-related causes (two of CMV disease, one of encephalopathy and one of autoimmune hemolytic anemia) and one of leukemia relapse. Non-relapse mortality at 100 days, 1 year and 2 years was 0.0%, 10.7% and 14.3%, respectively. At a median follow-up of 32.8 months (range, 17.0-72.5 months), the 2-year OS was 82.1%. OSs for nonmalignant diseases and malignant diseases were 94.4% and 60.0%, respectively (P=0.019). Thus, HHCT is a realistic alternative for patients with malignant or nonmalignant diseases who lack a suitable donor.
authors.affiliation: Asan Medical Center, Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Im
authors.affiliation: Asan Medical Center, Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: K N
authors.initials: KN
authors.lastname: Koh
authors.affiliation: Asan Medical Center, Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: J K
authors.initials: JK
authors.lastname: Suh
authors.affiliation: Asan Medical Center, Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Asan Medical Center, Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: E S
authors.initials: ES
authors.lastname: Choi
authors.affiliation: Asan Medical Center, Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S
authors.initials: S
authors.lastname: Jang
authors.affiliation: Asan Medical Center, Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Kwon
authors.affiliation: Asan Medical Center, Department of Laboratory Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Park
authors.affiliation: Asan Medical Center, Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: J J
authors.initials: JJ
authors.lastname: Seo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality / Q000517:prevention & control; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D007223:Infant; D008212:Lymphocyte Depletion; D008297:Male; D015996:Survival Rate