Effective T-cell replete haploidentical stem cell transplantation for pediatric patients with high-risk hematologic disorders
Issued Date
2023-03-01
Resource Type
ISSN
09024441
eISSN
16000609
Scopus ID
2-s2.0-85144066332
Pubmed ID
36451282
Journal Title
European Journal of Haematology
Volume
110
Issue
3
Start Page
305
End Page
312
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Journal of Haematology Vol.110 No.3 (2023) , 305-312
Suggested Citation
Tannumsaeung S., Anurathapan U., Pakakasama S., Pongpitcha P., Songdej D., Sirachainan N., Andersson B.S., Hongeng S. Effective T-cell replete haploidentical stem cell transplantation for pediatric patients with high-risk hematologic disorders. European Journal of Haematology Vol.110 No.3 (2023) , 305-312. 312. doi:10.1111/ejh.13906 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82676
Title
Effective T-cell replete haploidentical stem cell transplantation for pediatric patients with high-risk hematologic disorders
Other Contributor(s)
Abstract
Objectives: Patients with high-risk hematologic diseases require intensive modalities, including high-dose chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT). Haploidentical T-cell–replete transplantation is a logical choice because of the limited availability of matched sibling donors and the prolonged time needed to identify matched unrelated donors in Thailand. Methods: The clinical outcomes data of 43 patients undergoing allo-HSCT were reviewed. All patients had high-risk hematologic malignancies, were younger than 20 years, and were in complete cytological remission at the time of allo-HSCT. We used two different conditioning regimens: total body irradiation (TBI) combined with cyclophosphamide, fludarabine, and melphalan (n = 23) and thiotepa combined with fludarabine and busulfan (n = 20). All patients received a graft-versus-host disease prophylaxis regimen consisting of cyclophosphamide, mycophenolate mofetil, and a calcineurin inhibitor or sirolimus. Results: There was no difference in engraftment between patients receiving either of the regimens. After a median follow-up of 35.8 (range, 0.6–106.2) months, the overall survival (OS) and event-free survival (EFS) rates were 62.4% and 54.7%, respectively. OS and EFS were comparable between the respective regimens. Conclusions: We conclude that thiotepa-based conditioning has similar efficacy and tolerability as TBI-based conditioning for haploidentical HSCT with post-transplant cyclophosphamide.