Clinical study of a new protocol for acute graft-versus host disease prophylaxis in HLA-haploidentical bone marrow transplantation (BMT) / 中华血液学杂志
Chinese Journal of Hematology
;
(12): 416-419, 2003.
Artículo
en Chino
| WPRIM
| ID: wpr-354839
ABSTRACT
<p><b>OBJECTIVE</b>To explore the feasibility of a new protocol for acute graft versus host disease (aGVHD) prophylaxis in haploidentical bone marrow transplantation.</p><p><b>METHODS</b>Thirty-eight high-risk leukemia patients underwent haploidentical G-CSF primed bone marrow transplantation without ex-vivo T cell depletion, the donors were given G-CSF 250 microg/d for 7 days prior to marrow harvest. All patients received a same chemo-radiation conditioning regimen, including cytarabin, cyclophosphamide and total body irradiation (TBI). GVHD prophylaxis regimen consisted of ATG, CsA, MTX, Mycophenolate mofetil (MMF) and anti-CD(25) monoclonal antibody (MoAb).</p><p><b>RESULTS</b>All patients achieved engraftment of a median of 19 and 22 days for neutrophil and platelet, respectively. Cytogenetic analysis showed 100% donor hematopoietic cells in all recipients after transplantation. One of the twenty patients (5%) experienced grades II - IV acute GVHD. The recovery of CD(3)(+)CD(8)(+) T cells, CD(19)(+) cells and CD(56)(+) cells after transplantation was within 3 approximately 12 months. Of the 20 patients, 16 were alive with minimal and limited chronic GVHD and karnofsky score over 90% in a median follow-up of 9 months. Disease free survival (DFS) rates was (80 +/- 9)%.</p><p><b>CONCLUSION</b>G-CSF priming marrow graft along with sequential immunosuppressants, especially the addition of anti-CD(25) MoAb for aGVHD prophylaxis could achieve excellent engraftment, proper immune reconstitution and very low incidence of grade II - IV GVHD. The new protocol is effective and feasible in preventing severe acute GVHD and improving DFS.</p>
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Terapéutica
/
Donantes de Tejidos
/
Trasplante Homólogo
/
Leucemia
/
Estudios de Seguimiento
/
Trasplante de Médula Ósea
/
Movilización de Célula Madre Hematopoyética
/
Usos Terapéuticos
/
Alergia e Inmunología
/
Subunidad alfa del Receptor de Interleucina-2
Tipo de estudio:
Guía de Práctica Clínica
/
Estudio observacional
/
Estudio pronóstico
Límite:
Adolescente
/
Adulto
/
Niño
/
Femenino
/
Humanos
/
Masculino
Idioma:
Chino
Revista:
Chinese Journal of Hematology
Año:
2003
Tipo del documento:
Artículo
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