Allogeneic peripheral blood stem cell transplantation from two- or three-loci-mismatched related donors in adult Japanese patients with high-risk hematologic malignancies.

Abstract:

:With the increasing frequency of haploidentical transplantation, it is becoming more important to establish the degree of HLA mismatch that can be accepted. We retrospectively analyzed clinical data of 50 adult Japanese patients with high-risk hematologic malignancies who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from two- or three-loci-mismatched related donors with HLA class I and II gene disparities in the graft-versus-host direction. They were treated at 20 transplant centers between 1996 and 2002. In all, 18 patients received unmanipulated PBSC, while 32 received purified CD34+ blood cells. Conventional (n=31) or reduced-intensity (n=19) conditioning regimens were used. Of the 39 patients (78%) who survived for > or =28 days after transplant, 37 (95%) achieved neutrophil engraftment, while graft failure and rejection occurred in two of 39 (5%) and three of 37 (8%) patients, respectively. Stepwise Cox regression analysis revealed a significantly lower incidence of grades II-IV acute GVHD in patients receiving purified CD34+ cells (hazard ratio 0.32; 95% CI 0.12-0.84; P=0.022). By 1 year post transplant, 28 patients (56%) had died of transplant-related problems, including infectious complications (30%). Although the number of patients is small, our data suggest that transplant-related problems, particularly infectious complications, are major obstacles to the success of this therapy.

journal_name

Bone Marrow Transplant

authors

Yamasaki S,Ohno Y,Taniguchi S,Yoshida T,Hayashi S,Ogawa H,Shimazaki C,Takahashi S,Kasai M,Wake A,Nishimura M,Tokunaga K,Gondo H,Takaue Y,Harada M,Mineishi S,Japanese group for blood and marrow transplantation.

doi

10.1038/sj.bmt.1704342

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

279-89

issue

3

eissn

0268-3369

issn

1476-5365

pii

1704342

journal_volume

33

pub_type

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