PMID- 18608121
OWN - NLM
STAT- MEDLINE
DCOM- 20090320
LR  - 20220321
IS  - 0785-3890 (Print)
IS  - 0785-3890 (Linking)
VI  - 40
IP  - 6
DP  - 2008
TI  - HLA-mismatched/haploidentical hematopoietic stem cell transplantation without in 
      vitro T cell depletion for chronic myeloid leukemia: improved outcomes in 
      patients in accelerated phase and blast crisis phase.
PG  - 444-55
LID - 10.1080/07853890801908903 [doi]
AB  - BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) 
      remains the only proven curative therapy for chronic myeloid leukemia (CML), but 
      lack of human leukocyte antigen (HLA)-matched sibling or unrelated donors has 
      restricted its application. Recently, we developed an effective method for 
      haploidentical allo-HSCT achieving comparable outcomes to HLA-identical 
      transplantation. AIM: To evaluate the outcomes of CML patients who underwent 
      haploidentical allo-HSCT. METHODS: Ninety-three patients were treated with a 
      modified busulfan (BU)/cyclophosphamide (CY) 2 regimen, including antithymocyte 
      globulin followed by unmanipulated blood and marrow transplantation. RESULTS: Our 
      data showed that the cumulative incidence of acute graft-versus-host disease 
      (GVHD) was 64.52%, and grade III-IV was 26.45%, 61.79% had chronic GVHD, and 
      28.93% had extensive chronic GVHD. Non-relapse mortality varied at 8.72% (100 
      days), 20.72% (1 year) and 20.72% (2 years). Probability of 1-year and 4-year 
      leukemia-free survival was similar in chronic phase (CP) 1, CP2/CR2, accelerated 
      phase, and blast crisis patients. Probability of 4-year overall survival varied 
      as 76.5% (CP1), 85.7% (CP2/CR2), 73.3% (accelerated phase), and 61.5% (blast 
      crisis). Multivariate analysis indicated that factors affecting transplantation 
      outcomes were HLA-B+DR mismatches versus others for II-III acute GVHD and III-IV 
      acute GVHD, the stage of disease at transplantation for relapse, and the time 
      from diagnosis to transplantation for leukemia-free survival, overall survival, 
      and transplantation-related mortality. In our protocol, survival of HSCT for 
      advanced CML was similar to stable stage. CONCLUSIONS: For patients lacking an 
      HLA-identical related donor, haploidentical relatives are alternative HSCT 
      donors.
FAU - Xiao-Jun, Huang
AU  - Xiao-Jun H
AD  - Peking University Institute of Hematology, People's Hospital, Beijing, China. 
      xjhrm@medmail.com.cn
FAU - Lan-Ping, Xu
AU  - Lan-Ping X
FAU - Kai-Yan, Liu
AU  - Kai-Yan L
FAU - Dai-Hong, Liu
AU  - Dai-Hong L
FAU - Huan, Chen
AU  - Huan C
FAU - Wei, Han
AU  - Wei H
FAU - Yu-Hong, Chen
AU  - Yu-Hong C
FAU - Jing-Zhi, Wang
AU  - Jing-Zhi W
FAU - Yao, Chen
AU  - Yao C
FAU - Xiao-Hui, Zhang
AU  - Xiao-Hui Z
FAU - Hong-Xia, Shi
AU  - Hong-Xia S
FAU - Dao-Pei, Lu
AU  - Dao-Pei L
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Ann Med
JT  - Annals of medicine
JID - 8906388
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Blast Crisis/*therapy
MH  - Child
MH  - Directed Tissue Donation
MH  - Female
MH  - Graft Survival
MH  - Graft vs Host Disease
MH  - Hematopoietic Stem Cell Transplantation/*methods
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology/*therapy
MH  - Male
MH  - Middle Aged
MH  - Opportunistic Infections
MH  - Survival Analysis
MH  - Transplantation Conditioning
MH  - Transplantation, Homologous
MH  - Young Adult
EDAT- 2008/07/09 09:00
MHDA- 2009/03/21 09:00
CRDT- 2008/07/09 09:00
PHST- 2008/07/09 09:00 [pubmed]
PHST- 2009/03/21 09:00 [medline]
PHST- 2008/07/09 09:00 [entrez]
AID - 791361029 [pii]
AID - 10.1080/07853890801908903 [doi]
PST - ppublish
SO  - Ann Med. 2008;40(6):444-55. doi: 10.1080/07853890801908903.