PMID- 15205689
OWN - NLM
STAT- MEDLINE
DCOM- 20041019
LR  - 20171116
IS  - 1671-167X (Print)
IS  - 1671-167X (Linking)
VI  - 36
IP  - 3
DP  - 2004 Jun 18
TI  - [A novel approach to HLA-mismatched transplantation].
PG  - 229-33
AB  - OBJECTIVE: To investigate the new methods of human leukocyte antigen (HLA) 
      mismatched transplantation in patients with hematologic malignancies. METHODS: In 
      this pilot study, 58 patients, 33 with high-risk or advanced leukemia, were 
      transplanted with cells from an HLA-haploidentical family donor with at least 1 
      of 6 loci mismatched. After conditioning, patients received non ex vivo, T 
      cell-depleted grafts of G-CSF-primed bone marrow plus G-CSF-mobilized peripheral 
      blood stem cells, as well as graft-versus-host-disease (GVHD) prophylaxis. 
      RESULTS: All patients achieved sustained, full donor type engraftment. The 
      incidence of grades II-IV acute GVHD was 37.9% (22 of 58), and grades III and IV 
      aGVHD developed in only 2 and 1 patients, respectively. Furthermore, there was no 
      statistically significant association between the extents of HLA mismatching and 
      the degree of aGVHD. Twenty six of 42 (61.9%) evaluable patients had developed 
      chronic GVHD (cGVHD) with limited cGVHD in 15. Nine patients relapsed, all but 
      one with advanced or refractory leukemia. Fourteen patients died (24.1%), of whom 
      7 died of recurrent diseases and 7 of transplant-related complications (TRM): 
      main causes of TRM were infection(2), intestinal pneumonia(2), CMV 
      encephalitis(1), hepatitis(1) and aGVHD (1). Forty-four of the 58 patients 
      (75.9%) survived and 42 (72.4%) were disease free with a median follow-up of 10 
      months (range, 2 to 37.5 months). The 2-year probabilities of disease-free 
      survival for patients with standard and high risks were 77.6% and 63.2% 
      respectively, which showed that high-risk disease status at transplantation was 
      associated with worse disease-free survival (P=0.04). The degree of HLA 
      mismatching between the donor and the recipient was not related to event-free 
      survival (P=0.57), nor was cell number infused and aGVHD (P=0.78, 0.94 
      respectively). CONCLUSION: (1)HLA mismatched transplantation can be per formed 
      without ex vivo T cell depletion. (2)Using G CSF mobilized PBSCs as a source of 
      stem cells may be possible and safe even in HLA mismatched transplantation.
FAU - Huang, Xiao-jun
AU  - Huang XJ
AD  - Institute of Hematology, Peking University People's Hospital, Beijing 100044, 
      China. xjhrm@medmail.com.cn
FAU - Han, Wei
AU  - Han W
FAU - Xu, Lan-ping
AU  - Xu LP
FAU - Chen, Huan
AU  - Chen H
FAU - Liu, Dai-hong
AU  - Liu DH
FAU - Chen, Yu-hong
AU  - Chen YH
FAU - Jiang, Qian
AU  - Jiang Q
FAU - Lu, Jin
AU  - Lu J
FAU - Liu, Kai-yan
AU  - Liu KY
FAU - Ren, Han-yun
AU  - Ren HY
FAU - Lu, Dao-pei
AU  - Lu DP
LA  - chi
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Beijing Da Xue Xue Bao Yi Xue Ban
JT  - Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health 
      sciences
JID - 101125284
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Female
MH  - Follow-Up Studies
MH  - Graft vs Host Disease/prevention & control
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Leukemia/*therapy
MH  - Male
MH  - Pilot Projects
EDAT- 2004/06/19 05:00
MHDA- 2004/10/20 09:00
CRDT- 2004/06/19 05:00
PHST- 2004/06/19 05:00 [pubmed]
PHST- 2004/10/20 09:00 [medline]
PHST- 2004/06/19 05:00 [entrez]
PST - ppublish
SO  - Beijing Da Xue Xue Bao Yi Xue Ban. 2004 Jun 18;36(3):229-33.