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Buchumschlag von Transplantation of CD3/CD19 depleted allografts from haploidentical family donors in paediatric leukaemia
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Transplantation of CD3/CD19 depleted allografts from haploidentical family donors in paediatric leukaemia

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Zeitschriftentitel: British Journal of Haematology
Personen und Körperschaften: Lang, Peter, Teltschik, Heiko‐Manuel, Feuchtinger, Tobias, Müller, Ingo, Pfeiffer, Matthias, Schumm, Michael, Ebinger, Martin, Schwarze, Carl P., Gruhn, Bernd, Schrauder, Andre, Albert, Michael H., Greil, Johann, Urban, Christian, Handgretinger, Rupert
In: British Journal of Haematology, 165, 2014, 5, S. 688-698
Medientyp: E-Article
Sprache: Englisch
veröffentlicht:
Wiley
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Zusammenfassung: <jats:title>Summary</jats:title><jats:p>Transplantation of <jats:styled-content style="fixed-case">T</jats:styled-content>‐ and <jats:styled-content style="fixed-case">B</jats:styled-content>‐cell depleted allografts from haploidentical family donors was evaluated within a prospective phase <jats:styled-content style="fixed-case">II</jats:styled-content> trial in children with acute lymphoblastic leukaemia, acute myeloid leukaemia and advanced myelodysplastic syndrome (<jats:italic>n</jats:italic> = 46). 20 patients had active disease; 19 patients received a second or third stem cell transplantation (<jats:styled-content style="fixed-case">SCT</jats:styled-content>). Toxicity‐reduced conditioning regimens consisted of fludarabine or clofarabine (in active disease only), thiotepa, melphalan and serotherapy. Graft manipulation was carried out with immunomagnetic microbeads. Primary engraftment occurred in 88%, with a median time to reach &gt;1·0 × 10<jats:sup>9</jats:sup>/l leucocytes, &gt;20 × 10<jats:sup>9</jats:sup>/l platelets and &gt;0·1 × 10<jats:sup>9</jats:sup>/l T‐cells of 10, 11 and 50 days, respectively. After retransplantation, engraftment occurred in 100%. Acute graft‐versus‐host disease (Gv<jats:styled-content style="fixed-case">HD</jats:styled-content>) grade <jats:styled-content style="fixed-case">II</jats:styled-content> and <jats:styled-content style="fixed-case">III</jats:styled-content>‐<jats:styled-content style="fixed-case">IV</jats:styled-content> occurred in 20% and 7%, chronic Gv<jats:styled-content style="fixed-case">HD</jats:styled-content> occurred in 21%. Both conditioning regimens had comparable toxicity. Transplant‐related mortality (<jats:styled-content style="fixed-case">TRM</jats:styled-content>) was 8% at one year and 20% at 5 years. Event‐free survival at 3 years was: 25% (whole group), 46% (first, second or third complete remission [<jats:styled-content style="fixed-case">CR</jats:styled-content>], first <jats:styled-content style="fixed-case">SCT</jats:styled-content>) vs. 8% (active disease, first <jats:styled-content style="fixed-case">SCT</jats:styled-content>) and 20% (second or third <jats:styled-content style="fixed-case">SCT</jats:styled-content>, any disease status). This approach allows first or subsequent haploidentical <jats:styled-content style="fixed-case">SCT</jats:styled-content>s to be performed with low <jats:styled-content style="fixed-case">TRM</jats:styled-content>. Patients in <jats:styled-content style="fixed-case">CR</jats:styled-content> may benefit from <jats:styled-content style="fixed-case">SCT</jats:styled-content>, whereas the results in patients with active disease were poor.</jats:p>
Umfang: 688-698
ISSN: 0007-1048
1365-2141
DOI: 10.1111/bjh.12810