PMID- 17084371
OWN - NLM
STAT- MEDLINE
DCOM- 20070320
LR  - 20131121
IS  - 1083-8791 (Print)
IS  - 1083-8791 (Linking)
VI  - 12
IP  - 10
DP  - 2006 Oct
TI  - Unmanipulated HLA 2-3 antigen-mismatched (haploidentical) stem cell 
      transplantation using nonmyeloablative conditioning.
PG  - 1073-84
AB  - The major problems in human leukocyte antigen (HLA)-mismatched stem cell 
      transplantation (SCT) are graft failure and graft-versus-host disease (GVHD). 
      Less-intensive regimens should be associated with a lower release of inflammatory 
      cytokines and possibly less GVHD. The objective of this study was to investigate 
      whether HLA-haploidentical SCT can be performed using nonmyeloablative 
      conditioning and pharmacologic GVHD prophylaxis, including glucocorticoids. Using 
      conditioning consisting of fludarabine, busulfan, and anti-T-lymphocyte globulin 
      and GVHD prophylaxis consisting of tacrolimus and methylprednisolone (1 
      mg/kg/day), 26 patients who had hematologic malignancies in an advanced stage or 
      with a poor prognosis underwent transplantation using peripheral blood stem cells 
      from an HLA-haploidentical donor (2-3 antigen mismatches in the graft-versus-host 
      [GVH] direction) without T-cell depletion. All patients except for 1 achieved 
      donor-type engraftment. Rapid hematologic engraftment was achieved (neutrophils > 
      0.5 x 10(9)/L on day 12 and platelets > 20 x 10(9)/L on day 12), with full donor 
      chimerism achieved by day 14. Fifteen patients did not develop acute GVHD 
      clinically, and only 5 patients developed grade II GVHD. The recovery of CD4+ T 
      cells was delayed compared with that of CD8+ T cells. Sixteen of the 26 patients 
      are alive in complete remission. Four died of transplantation-related causes, and 
      6 died of progressive disease. These data suggest that nonmyeloablative 
      conditioning, GVHD prophylaxis consisting of tacrolimus and methylprednisolone, 
      and early therapeutic intervention for the GVH reaction allow stable engraftment 
      and effectively suppress GVHD in HLA 2-3 antigen-mismatched SCT.
FAU - Ogawa, Hiroyasu
AU  - Ogawa H
AD  - Department of Molecular Medicine, Osaka University Graduate School of Medicine, 
      Osaka, Japan. ogawah@hyo-med.ac.jp
FAU - Ikegame, Kazuhiro
AU  - Ikegame K
FAU - Yoshihara, Satoshi
AU  - Yoshihara S
FAU - Kawakami, Manabu
AU  - Kawakami M
FAU - Fujioka, Tatsuya
AU  - Fujioka T
FAU - Masuda, Tomoki
AU  - Masuda T
FAU - Taniguchi, Yuki
AU  - Taniguchi Y
FAU - Hasei, Hitomi
AU  - Hasei H
FAU - Kaida, Katsuji
AU  - Kaida K
FAU - Inoue, Takayuki
AU  - Inoue T
FAU - Kim, Eui Ho
AU  - Kim EH
FAU - Kawase, Ichiro
AU  - Kawase I
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (Cytokines)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - FA2DM6879K (Vidarabine)
RN  - G1LN9045DK (Busulfan)
RN  - P2K93U8740 (fludarabine)
RN  - WM0HAQ4WNM (Tacrolimus)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Adult
MH  - Antilymphocyte Serum/administration & dosage
MH  - Bone Marrow/drug effects/immunology/radiation effects
MH  - Busulfan/administration & dosage
MH  - CD4 Lymphocyte Count
MH  - Combined Modality Therapy
MH  - Cytokines/physiology
MH  - Disease-Free Survival
MH  - Family
MH  - Female
MH  - Graft Survival
MH  - Graft vs Host Disease/epidemiology/etiology/*prevention & control
MH  - HLA Antigens/*analysis/genetics
MH  - Hematologic Neoplasms/drug therapy/mortality/*surgery
MH  - *Histocompatibility
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Incidence
MH  - Male
MH  - Methylprednisolone/therapeutic use
MH  - Middle Aged
MH  - Myelodysplastic Syndromes/drug therapy/mortality/surgery
MH  - Peripheral Blood Stem Cell Transplantation/mortality/*statistics & numerical data
MH  - Recurrence
MH  - Remission Induction
MH  - T-Lymphocytes
MH  - Tacrolimus/therapeutic use
MH  - Tissue Donors
MH  - *Transplantation Conditioning/mortality
MH  - Transplantation, Homologous/*immunology
MH  - Treatment Outcome
MH  - Vidarabine/administration & dosage/analogs & derivatives
EDAT- 2006/11/07 09:00
MHDA- 2007/03/21 09:00
CRDT- 2006/11/07 09:00
PHST- 2006/03/19 00:00 [received]
PHST- 2006/06/07 00:00 [accepted]
PHST- 2006/11/07 09:00 [pubmed]
PHST- 2007/03/21 09:00 [medline]
PHST- 2006/11/07 09:00 [entrez]
AID - S1083-8791(06)00419-8 [pii]
AID - 10.1016/j.bbmt.2006.06.007 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2006 Oct;12(10):1073-84. doi: 
      10.1016/j.bbmt.2006.06.007.