4.2 Article

HLA-Haploidentical Peripheral Blood Stem Cell Transplantation with Post-Transplant Cyclophosphamide after Busulfan-Containing Reduced-Intensity Conditioning

期刊

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 21, 期 9, 页码 1646-1652

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2015.06.008

关键词

HLA-haploidentical transplantation; Post-transplant cyclophosphamide; Reduced-intensity conditioning; Busulfan

资金

  1. Regional Medicine Research Foundation (Tochigi, Japan)
  2. North Japan Hematology Study Group
  3. Japan Agency for Medical Research and Development (AMED) [15Aek0510012h0001]
  4. Grants-in-Aid for Scientific Research [15K15365] Funding Source: KAKEN

向作者/读者索取更多资源

Allogeneic hematopoietic stem cell transplantation (allo-SCT) using post-transplant cyclophosphamide (PTCy) is increasingly performed. We conducted a multicenter phase II study to evaluate the safety and efficacy of PTCy-based HLA-haploidentical peripheral blood stem cell transplantation (PTCy-haploPBSCT) after busulfan-containing reduced-intensity conditioning. Thirty-one patients were enrolled; 61% patients were not in remission and 42% patients had a history of prior allo-SCT Neutrophil engraftment was achieved in 87% patients with a median of 19 days. The cumulative incidence of grades II to IV and III to IV acute graft-versus-host disease (GVHD) and chronic GVHD at 1 year were 23%, 3%, and 15%, respectively. No patients developed severe chronic GVHD. Day 100 nonrelapse mortality (NRM) rate was 19.4%. Overall survival, relapse, and disease-free survival rates were 45%, 45%, and 34%, respectively, at 1 year. Subgroup analysis showed that patients who had a history of prior allo-SCT had lower engraftment, higher NRM, and lower overall survival than those not receiving a prior allo-SCT. Our results suggest that PTCy-haploPBSCT after busulfan-containing reduced-intensity conditioning achieved low incidences of acute and chronic GVHD and NRM and stable donor engraftment and low NRM, particularly in patients without a history of prior allo-SCT. (C) 2015 American Society for Blood and Marrow Transplantation.

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