Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2009-7-10
pubmed:abstractText
Severe graft-versus-host disease (GVHD) and graft rejection still remain major complications of haploidentical nonmyeloablative (NMA) stem cell transplantation. Recent studies have shown that bone marrow-derived mesenchymal stem cells (MSCs) possess immunomodulatory capacity and may promote hematopoietic engraftment. The purpose of this study was to observe if the new strategy, which included a haploidentical peripheral blood stem cell transplantation (PBSCT) combined with MSCs, modified NMA conditioning, and GVHD prophylaxis would improve donor engraftment and prevent severe GVHD. The modified conditioning approach consisted of fludarabine (Flu), low-dose total body irradiation (TBI), cyclophosphamide (Cy), cytarabine, and anti-Tcell-lymphocyte globulin, whereas the GVHD prophylaxis consisted of cyclosporin A (CsA), mycophenolate mofetil (MMF), anti-CD25 antibody and intrabone marrow injection of MSCs. Thirty-three patients with high-risk acute leukemia underwent transplantation with PBSC from HLA-haploidentical donors without T cell depletion. All of the patients achieved full donor chimerisms, including 6 who switched to full donor chimerisms from mixed chimerisms in 1 to 2 months after the transplantations. Rapid hematological engraftment was observed with neutrophils >0.5 x 10(9)/L at day 11 and platelets >20 x 10(9)/L at day 14. Fifteen patients (45.5%) developed grade I-IV acute GVHD (aGVHD) and only 2 (6.1%) developed grade III to IV aGVHD. Nine (31%) of 29 evaluable patients experienced chronic GVHD (cGVHD). Upon follow-up for 1.5 to 60 months, 20 (60.6%) patients were alive and well and 6 (18.2%) had relapsed leukemia in the 33 patients. The probability of 3-year survival was 57.2%. The results indicate that this new strategy is effective in improving donor engraftment and preventing severe GVHD, which will provide a feasible option for the therapy of high-risk acute leukemia.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
1523-6536
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
15
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
930-7
pubmed:meshHeading
pubmed-meshheading:19589482-Acute Disease, pubmed-meshheading:19589482-Adult, pubmed-meshheading:19589482-Aged, pubmed-meshheading:19589482-Chemoprevention, pubmed-meshheading:19589482-Combined Modality Therapy, pubmed-meshheading:19589482-Female, pubmed-meshheading:19589482-Graft Survival, pubmed-meshheading:19589482-Graft vs Host Disease, pubmed-meshheading:19589482-Haplotypes, pubmed-meshheading:19589482-Humans, pubmed-meshheading:19589482-Leukemia, pubmed-meshheading:19589482-Male, pubmed-meshheading:19589482-Middle Aged, pubmed-meshheading:19589482-Peripheral Blood Stem Cell Transplantation, pubmed-meshheading:19589482-Risk Assessment, pubmed-meshheading:19589482-Transplantation Chimera, pubmed-meshheading:19589482-Transplantation Conditioning, pubmed-meshheading:19589482-Treatment Outcome, pubmed-meshheading:19589482-Young Adult
pubmed:year
2009
pubmed:articleTitle
A modified haploidentical nonmyeloablative transplantation without T cell depletion for high-risk acute leukemia: successful engraftment and mild GVHD.
pubmed:affiliation
Department of Hematology and Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, People's Republic of China.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't