当前位置: X-MOL 学术J. Clin. Immunol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Haploidentical Hematopoietic Cell Transplantation Using Post-transplant Cyclophosphamide for Children with Non-malignant Diseases
Journal of Clinical Immunology ( IF 7.2 ) Pub Date : 2021-08-06 , DOI: 10.1007/s10875-021-01113-4
Hasan Hashem 1 , Rula Najjar 2 , Mayada Abu-Shanap 1 , Eman Khattab 1 , Rawad Rihani 1 , Abdelghani Tbakhi 3 , Iyad Sultan 1
Affiliation  

Haploidentical hematopoietic cell transplantation (HCT) is a valuable curative option for children with non-malignant diseases. Haploidentical HCT using post-transplant cyclophosphamide (PTCy) is a readily available option in the absence of an HLA-matched donor. We conducted a retrospective single-center study on the outcome of haploidentical HCT in children with non-malignant diseases. We gathered data from 44 patients underwent HCT in the period 2015 to 2020. The indications for HCT were bone marrow failure, primary immunodeficiency, metabolic disorders, and hemoglobinopathy. Median age at HCT was 4 years (range 0.7–20). The conditioning regimens were myeloablative (n = 17) or reduced intensity (n = 27). After a median follow-up of 20 months (range 4–71), 2-year overall survival was 89% and 2-year GvHD-free relapse-free survival (GRFS) was 66%. Incidence of primary graft failure was 13.6%. Cumulative incidence of grade II–IV acute and moderate/severe chronic GvHD were 20% and 6.4%, respectively. Younger age at HCT (< 4 years) and primary immunodeficiency were significantly associated with better GRFS (p < 0.05). In conclusion, haploidentical HCT using PTCy is feasible and curative in children with non-malignant diseases lacking an HLA-matched donor. Early diagnosis and referral in addition to timely treatment can further improve outcomes.



中文翻译:

非恶性疾病患儿移植后环磷酰胺单倍体造血细胞移植

单倍体造血细胞移植 (HCT) 是非恶性疾病儿童的一种有价值的治疗选择。在没有 HLA 匹配供体的情况下,使用移植后环磷酰胺 (PTCy) 进行单倍体 HCT 是一种现成的选择。我们对非恶性疾病儿童的半相合 HCT 结果进行了一项回顾性单中心研究。我们收集了 2015 年至 2020 年期间接受 HCT 的 44 名患者的数据。HCT 的适应症是骨髓衰竭、原发性免疫缺陷、代谢紊乱和血红蛋白病。HCT 的中位年龄为 4 岁(范围 0.7-20)。预处理方案是清髓性(n  = 17)或降低强度(n = 27)。中位随访 20 个月(范围 4-71)后,2 年总生存率为 89%,2 年无 GvHD 无复发生存率(GRFS)为 66%。原发性移植失败的发生率为 13.6%。II-IV 级急性和中/重度慢性 GvHD 的累积发生率分别为 20% 和 6.4%。HCT 年龄较小(< 4 岁)和原发性免疫缺陷与较好的 GRFS 显着相关(p  < 0.05)。总之,在缺乏 HLA 匹配供体的非恶性疾病儿童中,使用 PTCy 的半相合 HCT 是可行且可治愈的。除了及时治疗外,早期诊断和转诊可以进一步改善结果。

更新日期:2021-08-10
down
wechat
bug