scholarly journals T-Cell Replete Myeloablative Haploidentical Bone Marrow Transplantation Is an Effective Option for Pediatric and Young Adult Patients With High-Risk Hematologic Malignancies

2020 ◽  
Vol 8 ◽  
Author(s):  
Emmanuel Katsanis ◽  
Lauren N. Sapp ◽  
Susie Cienfuegos Reid ◽  
Naresh Reddivalla ◽  
Baldassarre Stea
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
T Cell ◽  
Young Adult ◽  
High Risk ◽  
Marrow Transplantation ◽  
Hematologic Malignancies ◽  
Adult Patients ◽  
Effective Option

Single-institute comparative analysis of unrelated bone marrow transplantation and cord blood transplantation for adult patients with hematologic malignancies

Blood ◽  
2004 ◽  
Vol 104 (12) ◽  
pp. 3813-3820 ◽  
Author(s):  
Satoshi Takahashi ◽  
Tohru Iseki ◽  
Jun Ooi ◽  
Akira Tomonari ◽  
Kashiya Takasugi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Cord Blood ◽  
Marrow Transplantation ◽  
Cord Blood Transplantation ◽  
Disease Free Survival ◽  
Hematologic Malignancies ◽  
Adult Patients ◽  
Transplant Recipients ◽  
Blood Transplantation

Unrelated cord blood transplantation (CBT) has now become more common, but as yet there have been only a few reports on its outcome compared with bone marrow transplantation (BMT), especially for adults. We studied the clinical outcomes of 113 adult patients with hematologic malignancies who received unrelated BM transplants (n = 45) or unrelated CB transplants (n = 68). We analyzed the hematopoietic recovery, rates of graft-versus-host disease (GVHD), risks of transplantation-related mortality (TRM) and relapse, and disease-free survival (DFS) using Cox proportional hazards models. The time from donor search to transplantation was significantly shorter among CB transplant recipients (median, 2 months) than BM transplant recipients (median, 11 months; P < .01). Multivariate analysis demonstrated slow neutrophil (P < .01) and platelet (P < .01) recoveries in CBT patients compared with BMT patients. Despite rapid tapering of immunosuppressants after transplantation and infrequent use of steroids to treat severe acute GVHD, there were no GVHD-related deaths among CB transplant recipients compared with 10 deaths of 24 among BM transplant recipients. Unrelated CBT showed better TRM and DFS results compared with BMT (P = .02 and P < .01, respectively), despite the higher human leukocyte antigen mismatching rate and lower number of infused cells. These data strongly suggest that CBT could be safely and effectively used for adult patients with hematologic malignancies.

Quantitation of T-cell neogenesis in vivo after allogeneic bone marrow transplantation in adults

Blood ◽  
2001 ◽  
Vol 98 (4) ◽  
pp. 1116-1121 ◽  
Author(s):  
Ephraim P. Hochberg ◽  
Antoinette C. Chillemi ◽  
Catherine J. Wu ◽  
Donna Neuberg ◽  
Christine Canning ◽  
...  
Keyword(s):  
Bone Marrow ◽  
T Cells ◽  
Bone Marrow Transplantation ◽  
T Cell ◽  
T Cell Receptor ◽  
Marrow Transplantation ◽  
Cell Receptor ◽  
Adult Patients ◽  
Thymic Function

Following myeloablative therapy, it is unknown to what extent age-dependent thymic involution limits the generation of new T cells with a diverse repertoire. Normal T-cell receptor gene rearrangement in T-cell progenitors results in the generation of T-cell receptor rearrangement excision circles (TRECs). In this study, a quantitative assay for TRECs was used to measure T-cell neogenesis in adult patients with leukemia who received myeloablative therapy followed by transplantation of allogeneic hematopoietic stem cells. Although phenotypically mature T cells had recovered by 1 to 2 months after bone marrow transplantation (BMT), TREC levels remained low for 3 months after BMT. T-cell neogenesis became evident by 6 months, and normal levels of adult thymic function were restored at 6 to 12 months after BMT. Subsequent leukemia relapse in some patients was associated with reduced TREC levels, but infusion of mature donor CD4+ T cells resulted in rapid restoration of thymic function. These studies demonstrate that T-cell neogenesis contributes to immune reconstitution in adult patients and suggest that thymic function can be manipulated in vivo.

scholarly journals Haploidentical, unmanipulated, G-CSF–primed bone marrow transplantation for patients with high-risk hematologic malignancies

Blood ◽  
2013 ◽  
Vol 121 (5) ◽  
pp. 849-857 ◽  
Author(s):  
Paolo Di Bartolomeo ◽  
Stella Santarone ◽  
Gottardo De Angelis ◽  
Alessandra Picardi ◽  
Laura Cudillo ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Bone Marrow Transplantation ◽  
High Risk ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Marrow Transplantation ◽  
Hematologic Malignancies ◽  
Hematopoietic Stem ◽  
Key Points

Key Points Haploidentical, unmanipulated, G-CSF–primed bone marrow transplantation. Haploidentical hematopoietic stem cell transplantation for hematologic malignancies.

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