T-cell-replete Haploidentical Stem Cell Transplantation is Highly Efficacious for Relapsed and Refractory Childhood Acute Leukaemia

Overview

Journal Transfus Med

Specialty Hematology

Date 2014 Sep 17

PMID 25224311

Citations 5

Authors

S Kobayashi

M Ito

H Sano

K Mochizuki

M Akaihata

T Waragai

Y Ohara

M Hosoya

H Ohto

A Kikuta

Affiliations

Soon will be listed here.

Abstract

Background: Despite improvements in first-line therapies, the outcomes of relapsed or refractory childhood acute leukaemia that has not achieved complete remission after relapse, has relapsed after stem cell transplantation (SCT), has primary induction failure and has relapsed with a very unfavourable cytogenetic risk profile, are dismal.

Objectives And Methods: We evaluated the feasibility and efficacy of T-cell-replete haploidentical peripheral blood stem cell transplantation (haplo-SCT) with low-dose anti-human thymocyte immunoglobulin (ATG), tacrolimus, methotrexate and prednisolone (PSL) in 14 paediatric patients with high-risk childhood acute leukaemia.

Results: All patients achieved complete engraftment. The median time to reaching an absolute neutrophil count of more than 0.5 × 10(9) L(-1) was 14 days. Acute graft-vs-host disease (aGVHD) of grades II-IV and III-IV developed in 10 (71%) and 2 (14%) patients, respectively. Treatment-related mortality and relapse occurred in one (7%) patient and six (43%) patients, respectively. Eleven patients were alive and seven of them were disease-free with a median follow-up of 36 months (range: 30-159 months). The probability of event-free survival after 2 years was 50%.

Conclusion: These findings indicate that T-cell-replete haplo-SCT, with low-dose ATG and PSL, provides sustained remission with an acceptable risk of GVHD in paediatric patients with advanced haematologic malignancies.

Citing Articles

Graft CD8 T cells for improving event-free survival after T cell-replete haploidentical stem cell transplantation in children with hematological malignancies.

Takahashi N, Mochizuki K, Kikuta A, Ohara Y, Kudo S, Ikeda K Int J Hematol. 2024; 121(3):403-410.

PMID: 39656374 DOI: 10.1007/s12185-024-03900-2.

Sub-myeloablative Second Transplantations with Haploidentical Donors and Post-Transplant Cyclophosphamide have limited Anti-Leukemic Effects in Pediatric Patients.

Epperly R, Talleur A, Li Y, Schell S, Tuggle M, Metais J Transplant Cell Ther. 2022; 28(5):262.e1-262.e10.

PMID: 35151936 PMC: 9081211. DOI: 10.1016/j.jtct.2022.02.007.

Effects of second transplantation with T-cell-replete haploidentical graft using low-dose anti-thymocyte globulin on long-term overall survival in pediatric patients with relapse of leukemia after first allogeneic transplantation.

Kobayashi S, Sano H, Mochizuki K, Ohara Y, Takahashi N, Kudo S Int J Hematol. 2021; 115(3):414-423.

PMID: 34822127 DOI: 10.1007/s12185-021-03266-9.

T-cell-replete haploidentical stem cell transplantation using low-dose antithymocyte globulin in children with relapsed or refractory acute leukemia.

Sano H, Mochizuki K, Kobayashi S, Ohara Y, Ito M, Waragai T Int J Hematol. 2018; 108(1):76-84.

PMID: 29508228 DOI: 10.1007/s12185-018-2423-5.

Long-term remission of HSCT-related NS after a second allogenic stem cell transplant.

Kobayashi S, Kawasaki Y, Sano H, Mochizuki K, Hosoya M, Kikuta A Pediatr Nephrol. 2015; 31(4):679-82.

PMID: 26659462 DOI: 10.1007/s00467-015-3254-8.

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