期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 17, 期 9, 页码 1335-1342出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2011.01.005
关键词
Hematopoietic stem cell transplant; T cell depletion; Unrelated donor; Hematologic malignancies
资金
- National Cancer Institute, National Institutes of Health [P01 CA23766]
- Aubrey Fund
- Tow Foundation
- Laura Rosenberg Foundation
We report a prospective phase 11 clinical trial in 35 adult patients (median age 40.5 years) with hematologic malignancies who received T cell depleted, hematopoietic stem cell transplants from HLA-compatible, unrelated donors. The cytoreductive regimen consisted of hyperfractionated total-body irradiation, thiotepa, and fludarabine. The preferred graft source was granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood stem cells (PBSC). PBSC were CD34(+) selected, followed by sheep erythrocyte rosetting to deplete residual T cells. Anti-thymocyte globulin provided graft rejection prophylaxis. No additional graft-versus-host disease (GVHD) prophylaxis was planned. Estimated disease-free survival at 4 years is 56.8% for the entire group and 75% in patients with standard-risk disease. The cumulative incidence of relapse is 6%. Acute GVHD grade II-III developed in 9% and chronic GVHD in 29% of patients. Fatal infections occurred in 5 of 35 (14%) patients. There was 1 late graft failure. This study demonstrates durable engraftment with a low overall incidence of GVHD. Its curative potential is reflected in the remarkably low relapse rate at 4 years. Bid Blood Marrow Transplant 17: 1335-1342 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
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