scholarly journals Anti-leukaemic activity of a novel haploidentical-transplantation approach employing unmanipulated bone marrow followed by CD6-depleted peripheral blood stem cells in children with refractory/relapsed acute leukaemia

2013 ◽  
Vol 162 (6) ◽  
pp. 802-807 ◽  
Author(s):  
Friedhelm R. Schuster ◽  
Roland Meisel ◽  
Monika Führer ◽  
Susanne Reuther ◽  
Julia Hauer ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Peripheral Blood ◽  
Acute Leukaemia ◽  
Peripheral Blood Stem Cells ◽  
Haploidentical Transplantation ◽  
Blood Stem Cells

Unmanipulated Haploidentical Blood and Marrow Transplantation in High Risk Hematologic Malignancies

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5527-5527
Author(s):  
Benakli Malek ◽  
Ahmed Nacer Redhouane ◽  
Bouarab Hanane ◽  
Baazizi Mounira ◽  
Zerkout Sara ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
High Risk ◽  
Peripheral Blood ◽  
Hematological Malignancies ◽  
Hemorrhagic Cystitis ◽  
Hematologic Malignancies ◽  
Peripheral Blood Stem Cells ◽  
Haploidentical Transplantation ◽  
Blood Stem Cells

Abstract Introduction: allogeneic haploidentical identical stem cells transplantation (SCT) is currently a salvage procedure in patients with hematologic malignancies at high risk and who have no HLA identical donor. The new modalities of haploidentical transplantation without in vitro T depletion of the donor, seem to allow rapid immune reconstitution and reduce the incidence of graft versus host disease (GVHD). This retrospective study presents the short-term results of this procedure in a single-center series, using a unmanipulated graft involving both bone marrow and peripheral blood stem cells after exposure to G-CSF donor. Material and Methods: From May 2013 to March 2015, 15 allografts SCT HLA-haploidentical were used in 14 pts with hematological malignancies (3 AML, 9 ALL, one acute CML and one lymphoblastic NHL). The median age is 24 years with a sex ratio of 2,5. Median time diagnosis-transplant is 27 months (2-74). At the time of transplant, 8 pts were in second complete remission and 3 pts in blast phase. The donor used was one of the two ascendants (father: 5, mother: 2) or sibling (brother: 5, sister: 3), median donors age 38 years (17-65). The degree of compatibility (HLA A, B and DR) is 3/6 (8 cases), 4/6 (6 cases) and 5/6 (1 case). CMV status between donor/recipient was high risk in 14 cases. ABO incompatibility is major in 3 cases, minor in 4 cases. The conditioning regimen associated Busilvex 9.6 mg/kg; Aracytine 8 g/m2; Endoxan 3.6 g/m2. The prevention of GVHD involved the Cyclosporine-Methotrexate association, MMF and Thymoglobulin 10 mg/kg. All pts received an association of bone marrow transplant and peripheral blood stem cells (from the donor receiving first G-CSF at a dose of 5 μg/kg) with a total average rate of NC: 8,9.108/kg , CD34: 11.29 106/kg (1,43-18,25), MNC: 8,9.108/kg (4.80-17.97), CD3: 3,61 108/kg (0.04-14), CD4: 1.36 108/kg (0,02-7.53), CD8: 1.24 108 (0,36-7.53). A second haploidentical allogeneic transplantation (from another donor) with Fluadarabine-Melphalan conditioning, was required in a pt who presented early rejection. Results: aplasia was observed in all pts with average duration of 21 days (15-21). The output is seen aplasia average J17 (12-23). No cases of VOD was observed. One pt presented an early rejection and received a second haploidentical transplantation. Acute GVHD occurred in 9 pts (64.2%) including 8 (57%) of grade II-IV; a chronic GVHD in 2 pts (18%) of extensive form. Seven pts (46%) developed CMV reactivation occurred in average d44 (35-67). Three cases of hemorrhagic cystitis (one grade 4) are observed on average d47 (30-75). Three pts (21%) relapsed four months after transplantation (all in blast phases at the time of graft). After a median follow-up of 11 months (4-25), 8 pts (58%) are alive and 6 pts (42%) died (digestive aGVH: 1, severe infection: 2, hemorrhagic cystitis: 1, relapse: 2). The actuarial overall survival and event-free survival at 28 months are 42.4% and 37.5% respectively. Conclusion: The results of the allogeneic SCT using unmanipulated haploidentical from the marrow and peripheral blood, after a myeloablative conditioning, seem encouraging in pts with hematological malignancies at advanced stages. Disclosures No relevant conflicts of interest to declare.

Cytokine-Mediated Expansion of 5-FU Resistant Peripheral Blood Stem Cells and Bone Marrow: Self-Renewal and Commitment Capacity*

1994 ◽  
Vol 3 (2) ◽  
pp. 135-139
Author(s):  
ALISON RICE ◽  
JEAN-MICHEL BOIRON ◽  
CAROLINE BARBOT ◽  
MARYSE DUPOUY ◽  
NADINE DUBSOC-MARCHENAY ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cells ◽  
Self Renewal ◽  
Blood Stem Cells

Haplo-Identical Allogeneic Stem Cell Transplantation Using GCSF-Mobilized Marrow Plus Blood Stem Cells from Parent Donors for Children with High-Risk Leukemia.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5084-5084
Author(s):  
Quanyi Lu ◽  
Xiaoqing Niu ◽  
Peng Zhang ◽  
Delong Liu
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
High Risk ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cells ◽  
Hematopoietic Stem ◽  
Blood Stem Cells

Abstract Increasing number of patients in China have difficulty of finding sibling donors due to limited number of siblings. We therefore explored the feasibility using haploidentical parent donors for allogeneic hematopoietic stem cell transplantation. Eight leukemia patients were studied in our hospital. These included 2 CML-BC, 2 MDS-RAEB, 3 relapsed ALL and 1 relapsed AML. The median age was 12 (7–17). GCSF- mobilized bone marrow and peripheral blood stem cells were collected from parents (1 to 3 locus mismatched). The conditioning regimen consisted of fludarabine (30mg/m2/d x5), bulsulfan (4mg/kg/d x3) and cyclophosphamide (50mg/kg/d x2). Cyclosporin A, mycophenolate mofetil, methotrexate, and ATG were used for GVHD prophylaxis. The total number of CD34+ cell in the grafts ranged between 5–10 x 106/kg. The median follow- up was 13 months (6–24). One patient failed to engraft, the other 7 patients achieved full donor chimerism at day 28. The incidence of acute GVHD (grade II-IV) was 57.1% (4 of 7). The incidence of chronic GVHD of limited stage occurred in the same 4 patients. One patient died of lung complication at 17th month, another patient with CML-BC relapsed 10 months after transplantation. The rest 6 patients are alive without disease. These results suggested that parents could be considered as stem cell donors in the absence of alternative donors for young patients with high-risk diseases. GCSF-primed bone marrow plus peripheral blood stem cells might be beneficial to reduce the risk of GVHD for leukemia children in China. More patients are needed to further study this approach.

Allogeneic Haematopoietic Stem Cell Donation — Current Status with Regard to Safety

2011 ◽  
Vol 07 (03) ◽  
pp. 211
Author(s):  
Alberto Bosi ◽  
Benedetta Bartolozzi ◽  
◽  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Haematopoietic Stem Cell ◽  
Current Status ◽  
Peripheral Blood Stem Cells ◽  
First Choice ◽  
Donation Process ◽  
Blood Stem Cells

Allogeneic haematopoietic stem cell transplantation (HSCT) represents the first choice of treatment or an important therapeutic option for numerous diseases. Several stem cell sources, such as bone marrow, mobilised peripheral blood stem cells and umbilical cord blood, are suitable for HSCT in clinical practice. However, this procedure is strongly related to availability of a histocompatible donor. In order to increase the probability of finding a histocompatible donor, national and international registries have been developed. Voluntary donation of bone marrow or peripheral blood stem cells for HSCT, both in the related or unrelated setting, is a well-established procedure with an invaluable ethical significance. Even if both procedures are safe, they are not risk free; therefore, the greatest attention has to be paid to the donor and to the donation process through a careful monitoring protocol for donor safety.

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